Do You E-mail Your Doctor?

Just about everyone seems to be online these days. Communication with family and friends via email and social media outlets including Facebook and Twitter, as well as texting appear to be replacing telephone calls and letter writing. We wonder what we may be losing in this shift: is our privacy being compromised? Are these news methods of communicating enhancing the depth of our interactions, or are they just surface? And what happens with our medical care?

Do you email your doctor? Would you want to? In late November, a new survey revealed that patients want digital engagement with their healthcare providers. Fierce Healthcare (11/29/12) reported on a survey that sought to examine types of relationships between patients and providers including how often, and through which channels they prefer to communicate. Called “Engaging the Healthcare Consumer and Improving the Patient Experience,” Varolii and the Patient-Centered Primary Care Collaborative (PCPCC)  report that the majority of consumers would embrace mobile interaction, like email and text messages, but few providers are reaching out to patients through these preferred channels. They also mention that patients with chronic conditions, such as diabetes, see the most benefit from being able to communicate with their provider and monitor their heath through mobile channels and smartphone web apps. They recommend that providers pay more attention to smartphone owners who are developing different patterns of engagement than other patients.

E-mailWhat do the doctors think? Does electronic communication compromise patient privacy and patient safety? Are their potential malpractice issues that need to be considered? Is face-to-face doctor/patient time still the gold standard? Would electronic communication be compensated? These questions, and others, need to be discussed and addressed by physician groups, and studies on this model need to be conducted and data analyzed, before we can definitively answer these questions.

Electronic communication is faster, more efficient & less costly.  In this era of healthcare reform, both providers and patients are looking for high quality health care at the lowest possible costs and best use of resources.  Many times, people head for the emergency department or urgent care when they are suffering from a bad cold or persistent cough. New electronic services, available for a subscription fee, mean that they can interact with the medical provider from the comfort of their homes with a click of a button- as long as they have the right equipment. A computer, webcam and Internet access is all that is needed in most instances.

This method is probably best used for more common, easily treated ailments rather than complex or chronic diseases, but it does represent a new modality of healthcare, and one I think we will definitely be seeing more often!


More on Medical Homes

Many folks still have questions about medical homes, so we thought we would try to answer some of your questions today.

Q. How does having a medical home benefit the patient?

Having a medical home means that you have a healthcare team to take care of you, headed by your primary care physician, who will coordinate your care and ensure good communication among your team members. The concept of “Care” appears to have evolved to “caring for the whole person,” so medical needs will certainly be addressed, but the patient’s social and family situation, mental health, and spiritual and emotional needs will also be considered.

Home Repair Doctor logo2a_fullQ. How is it different from having a PCP (Primary Care Physician)?

In some ways the concept isn’t that different. Your PCP should be the one who coordinates your care. Under this model, your PCP will work with an expanded team to ensure you are getting the care you need, at the right time, in the right place. Communication between team members is highlighted, and unnecessary care, such as duplicative tests, will be reduced, resulting in reduced costs.

Q. Will having a medical home cost me extra money?

This care model will not cost the patient any extra money. It is designed to enhance your health care while controlling costs to the system by ensuring you receive the care you need.

Q.  Isn’t this just a ploy for insurance companies to save money?

No. U.S. healthcare costs have long been trending upwards and have been deemed unsustainable. Research reveals that inefficiencies in the healthcare system and lack of communication between providers have lead to unnecessary and expensive care. We need to streamline how care is delivered to reign in spending; the Medical Home model will provide the best, most appropriate care for the patient in an efficient, cost-effective way. Although this model will result in cost savings at all levels, the patient is definitely the main beneficiary. The medical home model is sensible and cost-effective.

Q. Does this mean I won’t be able to get the care I need or want?

In the medical home model, the patient, and family members, if the patient desires, are an integral part of the healthcare team. Your voice will be an important factor in your care. The idea is not to deny care, but to coordinate care to eliminate unnecessary duplications of tests.

Q. Will this delay me seeing a specialist?

Your PCP will coordinate your care and refer you to a specialist when necessary.

Q. Is this like a “death panel?”

No. Actually, there were no death panels in any of the proposed health care reform plans. The Medical Home model seeks to provide the best, most coordinated and efficient care to the patient. The patient’s health and wellness is the primary concern.


The Patient-Centered Primary Care Collaborative has this to say:

“We also know that primary care — a single and continuous source for comprehensive care that considers the whole person, along with his or her family and community — supported by up-to-date and complete information that allows medical professionals to make good clinical decisions, has a far different outcome.

“Research studies in countries where patient-physician relationships focus on primary care consistently show that people live longer, populations are healthier, patients are more satisfied with their care and everyone pays less. These ‘primary care providers’ do more preventive health counseling, perform more screenings and immunizations, and provide care advocacy and coordination that lead to lower rates of death for heart disease, cancer, and stroke; and lower rates of hospitalizations for ambulatory care sensitive diagnoses like pneumonia. Chronic condition management and medical errors and omissions are significantly reduced with this ‘patient-centered’ primary care.

“Primary care is not gate keeping or restricting access to care. A primary care practitioner is a partner in care, a coach, an advisor and the person who assumes overall responsibility for coordinating care among all heath service providers, always focusing on the best interests and personal preferences of the patient.” (PCPCC Patient Centered Medical Home)

The medical home concept is meant to provide the coordination of care that other models, such as HMOs, failed to achieve. It’s a cooperative effort utilizing the latest medical science has to offer while eliminating unnecessary tests and treatments.


The ACA and Safety Net Resources

We hope you and your families enjoyed safe, happy and healthy holidays! Now that we are in the New Year, we have much to look forward to regarding healthcare in the U.S. As we’ve discussed in our previous three posts, we are moving towards insuring more people than ever before! That is good news, but there is much to be done. The ACA is not a perfect law, but it is our best opportunity to date to ensure that more Americans receive health insurance coverage.

Where We Are Now

At present, there are approximately 50 million uninsured people in the U.S. When the ACA has been fully implemented, we are hoping that number will drop to 25 million uninsured, a definite improvement, but by no means a cure!

One of the hallmarks of the ACA is the “medical home.” Medical home can be defined as follows (via National Center for Medical Home Implementation):1.23

A medical home is not a building, house, hospital, or home healthcare service, but rather an approach to providing comprehensive primary care.

In a patient-centered medical home model, the primary care team works in partnership with the patient and the family to assure that all of the medical and non-medical needs of the patient are met.

Through this partnership the care team can help the family/patient access, coordinate, and understand specialty care, educational services, out-of-home care, family support, and other public and private community services that are important for the overall health of the patient and family.

This model ensures that patients receive comprehensive, high-quality and cost-effective care by a care team that is coordinated and communicating.

Do you have a medical home? When choosing a primary care physician, a community health center, or free clinic, you can become part of a care team that will assist you in maintaining good health.

If you need assistance with finding a community health center or free clinic in your area, please visit our website at We can help you find your medical home.

What Does the Health Law Mean for Me?

Many of our NeedyMeds users have asked us to help them figure out what healthcare reform, or Obamacare, will mean for them and for their families or clients.  This is understandable because the law is complex, with both state and federal governments playing a role in implementation.

Some of the more common questions include these:

  • I am uninsured right now. The new law says I have to buy insurance. What happens if I can’t afford it? What will happen if I don’t buy it?
  • Can I keep the health insurance I already get from my work?
  • Can I get health insurance even if I already have health problems?
  • I am a senior citizen. What will happen to my health coverage with the new law?

To help answer these and other questions, and provide clear guidance, we recommend reading Kaiser Health News’ “A Consumer’s Guide To The Health Law,” which provides a clear and concise overview of the ACA.


Some analysts argue that there could be modifications to reduce federal spending as part of a broader deficit deal; for now, this is just speculation. What is clear is that the law will have sweeping ramifications for consumers, state officials, employers and health care providers, including hospitals and doctors.

While some of the key features don’t kick in until 2014, the law has already altered the health care industry and established a number of consumer benefits. For example, the extension of coverage to adult children up to age 26, the elimination of lifetime spending caps and ability for people with pre-existing conditions to obtain coverage have help many Americans.

Kaiser Health News article primer on parts of the law already up and running, what’s to come and ways that provisions could still be altered. Now that President Barack Obama has won a second term, the Affordable Care Act is back on a fast track.

We still don’t know the full impact of this act and it may be implemented differently in different states. There’s no denying that, overall, it will result in more people having health insurance coverage.

Affordable Care Act – Here to Stay

The outcome of the November Presidential election also decided the fate of the Affordable Care Act (ACA). Ron Pollack, Executive Director, Families USA says: “The election has settled key issues about the directions our nation’s healthcare will take: It means Obamacare will be implemented, the Medicaid safety net will be strengthened, and Medicare’s guaranteed benefits will not be undermined. As a result, people across America will gain peace of mind knowing that high-quality, affordable healthcare will be there for themselves and their loved ones,”(Healthcare Finance News). This means that implementation will go forward.

This is good news for all Americans, but especially for those who are presently uninsured. But how will this work?  The ACA has two main pillars, each of which will be decided on a state-by-state basis:

1) Create a health insurance exchange

2) Expand Medicaid

Each state will have the option of setting up their own health insurance exchange (state-run), allowing the federal government to set up and operate an exchange on behalf of the state (federally-run), or create a state-federal partnership where both entities will cooperatively set up and run the exchange.

What is a health insurance exchange? It can be defined as an online insurance marketplace where consumers can choose from a number of health insurance plans. “The exchanges are supposed to make it easier and more transparent for small businesses and millions of individuals who are not covered through their employers to shop for health insurance,” according to the Washington Post (Obama’s health-care law still faces challenges…).  Consumers will be able to compare plans and choose the one that best fits their healthcare needs and income.

Regarding Medicaid expansion, the Pew Center states: “States must also decide whether they want to accept generous federal funding to expand their Medicaid programs to cover millions more people,” (Pew States – Stateline).  Federal funds will cover this initially, but states will be asked to cover 10% of the cost eventually. Again, we are awaiting the states’ individual decisions on whether to expand Medicaid, and we will keep you up-dated.

For more information, we recommend this website:, this provides the most current analysis of the Health Care Law.


Please post your comments and questions and we will respond. NeedyMeds wants to be YOUR health safety net resource!