Hospital New Hampshire

Last week, I drove all around the state of New Hampshire with a film crew, talking to various community health clinics, physician group practices and hospital-associated groups about a radical new concept called Patient-Centered Medical Home: the idea that every patient should have a primary care doctor in a consistent setting. Where a patient is known and welcomed. Where all aspects of their medical care are coordinated (even those things may not immediately seem related to medical care, like getting a ride or getting all your forms filled out). Where a patient is an active consumer of healthcare, an accountable partner in their own health outcomes. Where healthcare providers are paid not only for a visit or procedure, but for all the services they and their staffs provide, from phone calls to referrals to refills. Where people get better — and the system gets better. Really, the idea is not so radical or new: it's old-fashioned family medicine, the kind my grandfather practiced. They are doing good things in New Hampshire. Wherever you stand politically, we can probably all agree that our very flawed healthcare system should realign around people getting better.

After five days in New Hampshire, I landed in Austin and fetched my much-missed children, only to receive the phone call that Jim Dear (Granddaddy) was being admitted to the hospital with an abdominal aortic aneurysm. The fact that they caught it is a miracle, and while the situation is serious, we are optimistic that Dad will recover from the surgery scheduled on Tuesday. We've been happy with the care he's received so far: mostly efficient, caring and effective.

But it's nothing like what I witnessed in New Hampshire. It would mean the world to me and my sisters and my dad to have a Medical Home right now: someone to call and ask the 72 odd questions we have, someone to help us understand what the hell the out-of-pocket maximum is for Medicare Part A (oh, and what the hell is the difference between Part A and Part B), someone to help us get a second opinion about the stent vs. the open surgery. We are Medical Home...less. For all the good care he is receiving, we are adrift in a sea of questions.

Ah, New Hampshire. Keep up the good work.