What is a patient-centered medical home? To some it means the place you go to get health care – full primary care and a convenient and efficient entry path into more specialized services. To others it means a way of organizing the business of health care to make it more accountable for reducing costs, guided by the dictates of private insurers and government bureaucrats implementing the Affordable Care Act.
There was a time when family medicine saw itself as a counter-culture in medicine with a mission to incorporate a different set of values. Our job should be to improve the wellbeing and health of our patients and their communities, not the bottom line of the corporations who thrive off our labor.
Such a dream will not happen until health care is seen as a public good instead of a private commodity. A national health system, it seems, is the only economically rational and humane way forward.