Without getting out of my chair: A medical home

Robert Williamson, a 60-year-old Philadelphia resident, recalls the cursory exam he received a few years ago from a harried doctor who missed seeing some danger signals, and sent him home. Robert had a stroke a short time later. He had to stop working as a customer service representative, and go on Social Security disability.

Missed diagnoses like these should occur more rarely with his new doctor. "I give him my heart and diabetes readings by email and phone, without getting out of my chair," Robert says. "I can get better directions, at the very moment I need them. It's life-saving."

Some of the area's largest insurers are conducting an experiment with 100 physicians. In addition to paying for office visits, the insurers are paying the medical groups to keep better track of their patients by phone and email. The doctors are encouraged to hire additional staff to monitor patients' treatment and follow-up, and send reminders for mammograms, colon exams, and other forms of early detection. Robert's doctor has hired a patient educator and has acquired supporting technology.

This model of primary care provides a "medical home" where doctors, patients and families will ideally pull together as a big, happy family. Insurers are studying whether this will lower their costs and improve patient satisfaction.

Advice: Ask your primary care physician whether he or she can contact you proactively and regularly about follow-up care and upcoming appointments for early detection.

Read another story on how a more modern doctor's office feels to a patient.

Thanks to Milt Freudenheim for the source story in the July 21 issue of the New York Times.