My daughter was 5 months old when she got her first ear infection, which was accompanied by flu-like symptoms, high fever, lots of snot, vomiting and pain. Thus began a cycle that would last until she was almost 2 years old. We would adhere religiously to our antibiotic regiment and ibuprofen/ acetaminophen routine, and after several weeks of smooth sailing it would start all over again. Eventually she was diagnosed with childhood asthma and chronic otitis media and she was on a regiment of inhalers, nebulizer treatments, and several allergy medications. The poor child could practically operate the nebulizer before she could walk.Little did we know, our pediatric practice had many elements of the Patient Centered Medical Home. We loved it. Here is what it felt like to us.
Friends of ours recommended the doctor, who I'll call Dr. V. The practice was set up so each patient selected their personal doctor. Whenever we called to make an appointment, they addressed us by name and told us when Dr. V's next appointment was. It was always the same day (except well-child visits which we scheduled well in advance). We saw her every time with very few exceptions. When I would call with the occasional question, I would leave a message with Dr. V's nurse (who also knew us by name) and she would return my call within 2 hours. After hours, they had an agreement with the closest hospital to answer urgent calls.
For questions about a problem we thought our daughter was having, they encouraged us to first look on their website which had a list of common illnesses, symptoms, and their recommended course of action depending on the severity. I feel like I looked at their website at least once every few weeks! It really helped us decide what to do. I could also email them if I wanted to, but I never needed to use this function because they were so responsive to phone calls.
At the end of every visit (of which there were a lot!), Dr. V would give me a printed summary of what happened during the visit, my child's diagnosis, and our agreed-upon course of action, along with frequency of her medications and what to do in case of a bad reaction. She would make sure she answered all our questions.
Eventually, we decided to get ear tubes for our daughter. It was a godsend and changed our worlds. When the decision was made, Dr. V arranged the appointment with the specialist to have the procedure done, and followed up with us afterwards to see how it went. Another time, our daughter had a febrile seizure and went to the emergency room in an ambulance (that's another story!). The next day, Dr. V called us wanting us to come in and see if everything was alright. I was so impressed that she knew we had been to the ER! Another time, we called the after-hours line and again, Dr. V followed up with us the next day to see if everything was alright. What I then thought was just great customer service, I now realize as also great medicine.
During all of this, my husband I both worked full-time. I exhausted my leave going to all these appointments (and was exhausted in general!). But the clinic had Saturday hours which was soooo helpful to us on several occasions.
I really could tell that she cared about my child and our entire family. She will never know how grateful I am for the breastfeeding encouragement she gave me. Dr. V was so excited when we appeared for an appointment and told her we were expecting another baby! And she was so sad when we told her we were moving to another state. I miss her and that practice; they were kind of like an extension of our family. And our home.
Knowing what I know now about Patient Centered Medical Home, they hit many of the high notes. They would probably easily qualify for Level 2 or 3 NCQA PCMH status. It is sad that I felt lucky in our practice, compared to stories I heard from friends and others. I wish everybody were so lucky... and that "lucky" becomes commonplace as this becomes everybody's experience.
Think about your practice. What would your patients' experience stories sound like?
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