Some envision return to a more familiar form of health care

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SALT LAKE CITY -- Part of President Obama's plan to reform health care may draw on a philosophy that was practiced many years ago. But instead of being old-fashioned, health reformers envision this version as sort of a trip "back to the future."

How many movies have we seen where the doctor makes a house call? He knows the family well. He knows their health needs. He feels comfortable with his patients, and likewise, they with him.

Home medical-based care may be where we're headed again in this era of reform, but in a much more contemporary way.

"Everybody deserves a personal physician who knows them, who takes responsibility for all of their care," said Dr. Michael Magill, with University of Utah Family and Preventive Medicine.

Magill talks about a concept as old as the Oath of Hippocrates itself. But this time, the primary-care physician would have lots of help.

"The need for a personal healing relationship with someone who enters into a covenant relationship with you to be responsible for your care is still as important now as it ever was," he said.

With new tools for record keeping, a better understanding of preventive medicine and a team to back up the primary-care physician, this new model, already in use in two Utah clinics, appears workable.

"Part of the promise is to be available," Magill said. In other words, if you call today, you're seen today. The team immediately pulls up you're electronic records, you quickly move into an exam room, and the doctor sees you right away.

The primary-care team knows you and how to customize preventive care for your family. Outside the clinic, you can e-mail anytime. "E-mail, including the ability to look up your own laboratory tests online, look into your own medical records, make your own appointments online," Magill said.

In theory, quality of care goes up while costs come down. Medical Home could be part of the state's planned demonstration project early next year. That reform package involves input from physicians, local health care providers and services, insurance carriers and state agencies.


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Ed Yeates


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