"We know that it hits patients the wrong way," says Dr. Somava Stout of Cambridge Health Alliance, a Harvard University-affiliated public healthcare system. She was just promoted to the new position of vice president for patient-centered medical-home development.
"They think of nursing homes, funeral homes, so there's a negative connection there," Stout adds. "I don’t know if we can do anything about the term now, because it's been out there for a while—but we can explain it for them and let them know what it means."
The National Committee for Quality Assurance, an organization that has formally recognized more than 1,500 practices as medical homes, has given the subject a lot of thought.
"We tortured ourselves about what to do about that name because it doesn't bring to mind what a medical home is," says Patricia Barrett, NCQA vice president for product development. "They don’t like the name; they think of something with bricks and mortar—like a nursing home."
The problem, however, is that nobody appears to be able to come up with a better term. Barrett says consumers and providers were offered alternatives to "medical home," but "no other name grabbed them."
"We’re not planning to change the name of the program now, because it’s what people know," she says.
Geoffrey Charlton-Perrin, director of marketing and communication for the Accreditation Association for Ambulatory Health Care, says one problem is that the concept gets defined "depending on the angle of the company promoting it." An electronic health-record systems provider, for example, will promote information technology as the main ingredient of a medical home.
"I do know that there is a work to be done in explaining what a medical home is—even to the medical profession," Charlton-Perrin says.
"I don’t think anyone has come up with a definition that everyone agrees is right," he adds. "Our angle is that there should be a direct relationship between the physician and the patient."
The patient-centered medical-home model is most often promoted for patients who are seeing multiple providers for chronic conditions. While the doctor who coordinates the care is usually thought to be a primary-care physician, this role also can be filled by a specialist such as a cardiologist or oncologist. There's a name being tossed around for this that Stout doesn’t particularly like: gatekeeper.
"I have yet to meet a primary-care doctor who wants to be a gatekeeper," she says. "It’s not about a gatekeeping relationship, it's about care coordination.”
For more news on the latest developments in medical homes, please read my story in the Feb. 7 issue of Modern Healthcare.