By: Kristina E. Malik, MD, FAAP
A medical home is the partnership between you, your child, and your child’s medical team. It is not a house or a hospital, but a plan to care for a child keeping in mind all aspects of their health. That includes their family’s wellness.
What does a pediatric medical home look like?
The American Academy of Pediatrics (AAP) recommends that great care for babies, kids, teens and young adults should look like this:
The health care team should be ready to take care of children’s critical needs. They can do that in-person, via phone or working together with urgent care providers.
When your health care team works this way, they make care accessible for you and your child.
Ideally, the same team should care for a child over the years and work with their family. Together, they should plan for transitions to other pediatric providers or into the adult health care system.
When the same team works with you over the years, they make sure the care they give your child is continuous.
Medical care should cover all aspects of a child’s well-being. The medical team should not only include the primary doctor. It should also include dieticians, nurses, mental and behavioral health professionals and care coordination providers.
When your care team covers all aspects of your child’s health, they are giving them comprehensive health care.
Care plans need to focus on what the child and the family need, as well as their individual situation. It’s important to adapt plans to the family’s culture.
When medical homes reflect the communities they serve and promote that all families have access to health care, they are family-centered and culturally effective.
The medical team should respond with empathy to the child’s and family’s needs or concerns. They should use them to propose care plans. Then, the medical team should decide with the family how those plans will look like before putting them into action.
When your medical team listens to your needs carefully and uses them to design a care plan for your child with you, the care they provide is compassionate.
All pediatric care providers, including community service providers inside or outside the medical home, should work together to create management plans in partnership with the child and family.
When your medical team works with external medical professionals and you to make sure your child gets the care they need, they are showing they can give you coordinated care.
You and your child's primary doctor: the heart of your medical home
The heart of a medical home is the partnership with your child’s primary doctor. This relationship should be based on trusting each other and working together.
Through this partnership, you can access special care from other doctors. You can also organize when and how you get that care. Finally, you can access education services, home care, family support and other community resources that are important for you child’s wellbeing.
Your child’s primary care doctor should be well-trained to:
Partner with your child and family.
Identify and take care of the unique needs your child and family have.
Provide physical, behavioral, developmental, emotional and social health care. If they can’t help you provide all those types of care, they should help you find alternatives.
Create your child’s "medical neighborhood," with the medical home at the center for coordination and communication.
What services are part of comprehensive care?
In a medical home, doctors take care of the medical and non-medical needs of a child and their family. Comprehensive care goes beyond emergency care or caring for medical needs when there is a chronic health condition. It includes:
Preventive screenings
Growth and developmental evaluations
Health surveillance
Patient and parent counseling about nutrition, safety, parenting and mental health
Care outside of your medical home: the medical neighborhood
All care providers (inside and outside the medical home) should work together to create shared management plans. They should partner with the child and their family to create those plans.
Providers in a medical home should also identify when a child needs a referral for care outside the medical home. They should communicate with the external providers and coordinate the care needed. That care includes:
Medical specialists
Surgical specialists
Therapists
Community services
Early intervention programs
School programs
Early childhood education and childcare programs
Programs in other public and private community agencies
Where can children receive care from their medical home?
Children can get medical care in a number of places: a pediatrician’s office, a hospital outpatient clinic, a community health center or a school-based clinic. Any of those places can be part of a medical home, as long as the care children get there is part of what a medical home can give them.
Emergency or occasional care from drugstore chains or walk-ins should not replace the long term care a medical home can give. Having a care team you know and trust —who also knows your child and trusts you—gives your child a better chance at staying healthy.
How to improve your medical home
You can work with your primary care doctor and their team to make your child’s medical home better.
A few questions you can ask to spark a conversation:
How can we, as parents, help you become an even better medical home?
Does your office have a ‘family advisory council’? I would like to talk to them about improving parents’ experience. If you don’t have one, how can we work together to create it?
How can we work together to create:
Extended access to care
A patient satisfaction survey
Accessible waiting and exam rooms
Patient and family education materials or lists with resources
Expand the care team to include other health professionals: mental and behavioral health providers or dieticians
Let your doctor know how important these improvements are to you and your child’s medical home.
About Dr. Malik
| Kristina E. Malik, MD, FAAP, is a certified pediatrician. She works at the Special Care Clinic in the Children's Hospital Colorado. She provides comprehensive care for children with disabilities and difficult health conditions. She is also an Associate Professor of Pediatrics at the University of Colorado Anschutz School of Medicine. Dr. Malik is a member of the AAP Section on Home Care and a co-author of the Medical Home policy for AAP. |