Perceptions of Becoming Personal Physicians within a Patient-Centered Medical Home

The allopathic and osteopathic primary care professional disciplines, including the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association, are committed to providing comprehensive primary care for children, youth and adults in a health care setting that facilitates partnerships between individual patients, their personal physicians, and when appropriate, the patient’s family via the Patient Centered Medical Home [PCMH] [1]. Within the PCMH, the term “personal physician” has been defined as a person with an ongoing patient relationship who is trained to provide first contact, continuous and comprehensive care [1]. With healthcare reforms continuing to move toward the PCMH [1-7], much research has focused on the potential benefits such an approach could make toward improving quality of care while containing costs [3-6]. The idea of being a personal physician and the need for educational redesign to address being a personal physician are not new. In 1926, Dr. Francis Peabody underscored the need for the good physician to know his/her patients completely, as in many cases both appropriate diagnosis and treatment can depend on a personal relationship between patients and physicians [8]. Similarly, in 1960, Dr. Fox [9] indicated that, “The more complex medicine becomes, the stronger are the reasons why everyone should have a personal doctor who will take continuous responsibility for him... the doctor treats people, not illnesses...”. The role of the physician continues to expand in the current decade with additional physician directives as part of the PCMH movement, such as [1] leading a team of individuals who collectively take responsibility for the ongoing care of patients; [2] taking responsibility for all of the patient’s healthcare needs rather than just illness needs, such as providing preventive services and end of life care; [3] integrating care across all elements of complex health care systems and the patient’s community; and [4] providing care that is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner [1]. With this movement, the types of competencies that physicians need within the context of PCMH are quite different from the competencies physicians have needed in the past.