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Vital Signs


Vital Signs

Fall 2011

Finding a Place to Call a “Medical Home”


VS-Fall11-Medical HomeSixty million people — about one-in-five — say they do not have a regular doctor or clinic to receive medical care, according to a recent report from the Agency for Healthcare Research and Quality. This number may decrease as more people gain access to health insurance under healthcare-reform legislation, but finding the right doctor could prove challenging, experts say.

“Nationally, the primary care infrastructure is stretched to the limit,” explains Mark Grossman, M.D., chief medical officer of the UCLA Community Physicians Network (CPN). “Our focus has been on expanding our network of community-based, primary care physicians for many years because we know that when patients have a true medical home, they are more satisfied and experience better health outcomes.”

A patient-centered “medical” or “health home,” according to joint principles outlined by key physician groups in the U.S., is an approach to providing comprehensive primary care in which a physician or team of physicians and support staff partner with patients and their families to coordinate care across the healthcare continuum and within the patients’ communities. They use tools that may include registries, information technology and health-information exchanges, with the goal of facilitating access to culturally and linguistically appropriate healthcare.

To address increased demand for primary care as healthcare reform is fully implemented, UCLA has continued to add communitybased primary care offices to expand primary care access — including family and internal medicine specialists and pediatrics — for Westside and Santa Monica residents. Additional primarycare services also are being added through the UCLA Department of Medicine and UCLA-Santa Monica Bay Physicians.

In addition, 45 percent of the 2011 graduating class of David Geffen School of Medicine at UCLA chose residencies in primary-care specialties, a 5 percent increase from the previous year. Nationally, however, the trend is the opposite. The number of U.S. medical school graduates selecting a career in family medicine, for example, dropped nearly 30 percent from 2002 to 2007. National trends notwithstanding, primary care continues to emerge as a complex and increasingly important profession, according to Janet Pregler, M.D., director of the Iris Cantor- UCLA Women’s Health Center.

“Fifty years ago, people died of their first major illness because we didn’t know as much,” Dr. Pregler says. “Today, people often live a long time with several medical problems and need coordinated care by one physician with general knowledge about many health conditions. That’s what primary care doctors do.”

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