Generation Exodus? Are Medical Homes the Answer?

For months, I have read of a growing exodus of nurses and primary care physicians from the bedside. Just this morning, I listened to an NPR discussion about the growing shortage of primary care physicians. Letâ??s face it. Compared to generations of health care professionals in the past, this new generation of providers faces unique obstacles and hurdles. In addition to high and heavy patient loads, many new grads (nurses and doctors) face soaring debts, endless documentation requirements, looming liabilities, and frequent public criticism. At the same time, these same health care professionals often face attractive alternative positions both inside and outside the health care arena. Can we realistically prevent them from leaving our ranks for greener pastures?

No doubt current economic concerns have provided a temporary respite from the potential hemorrhage of health care professionals away from patient care. But, permanent relief is unlikely, as the aging population of nurses eventually decides to retire â?? even if later than originally planned; and, an increasing number of new physicians choose to specialize â?? an option which can be more lucrative and predictable than primary care.
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So, what is the answer to these professional and patient woes? Some patients and health care professionals advocate Patient-Centered Medical Homes (PCMH). The PCMH is not a new idea. It originated in a simpler form in the 1960s, as a form of pediatric care. The central idea behind Medical Homes is that each patient receives coordinated, team-managed, and comprehensive health care. This includes preventative, prompt, individualized and integrative approaches to their overall health. Most PCMH models utilize electronic health records in order to assure well coordinated and holistic patient care. They also carry a strong emphasis on evidence-based practices. Online care and group visits are also part of the model, and may be especially helpful for chronic conditions such as obesity and diabetes.
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Critics argue that, while many primary care providers currently provide patient education during visits, most donâ??t provide adequate follow-up between visits. Perhaps this is where nurses can fill the gap. I recently heard of patients using cell phones to transmit vital signs to their providers, between visits. I have also seen models where patients directly download lab values, such as blood glucose, from home to provider.
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Nurses may be ideally situated to act as liaisons and health care coaches in a Medical Home model. And, perhaps, Nurse Practitioners can step into vacancies left by primary care providers.
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Do you think that we face a shortage of nurses and primary care physicians? What do you think is the answer?

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Generation Exodus? Are Medical Homes the Answer?Originally from: http://feedproxy.google.com/~r/NursingAndCareer/~3/PLQDd-DcFDQ/BlogPostDetail.aspx

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