An argument for comprehensiveness as the "special sauce" in a recipe for the patient-centered medical home

Abstract

How can we study and quantify potential value that may be added by having primary care specialists (PCSs) from both family medicine and internal medicine provide preventive care services for women? Does seeing one's personal physician (PCP) make a difference? Early answers come from the study by Cohen and Coco in this issue: "Do physicians address other medical problems during preventive gynecologic visits?" Their assessment of a nationally representative sample of preventive gynecological visits uses self-reported data from the physicians to tell us "yes" and to quantify to what extent by specialty, region, and PCP status. This sampling of the content of women's preventive health visits allows us to get a flavor for how the majority of PCSs provide comprehensive care for concomitant acute and chronic issues in the context of individual preventive care visits. Patients are unlikely to parse their presenting concerns into the acute or chronic or preventive categories. The practice of addressing multiple issues during one visit improves the efficiency of addressing patient concerns. This may be a key to the special flavor of a true patient-centered medical home.