Supporting Patient Engagement in the Patient-Centered Medical Home

The idea of the patient-centered medical home as a possible solution to the problems that arise from poor-quality, fragmented, expensive health care has attracted interest from a wide range of stakeholders. The principles that characterize the patient-centered medical home describe the responsibilities and attributes professionals and institutions that must be met in order to qualify as a legitimate medical home (Patient-Centered Primary Care Collaborative, 2008).

Included in these principles are general accounts of how patients should be treated: that their preferences should be respected, their emotional needs attended to, their autonomy supported and their decisions shared with families and the care team (Wachter, R. 2008).

What is lacking from the model of the medical home is recognition that patients are not the object of care, but are rather that they are full-fledged participants in it – and unless that participation is active and informed, the impact of health care, whether services, drugs, surgery or devices, is severely muted. People who are unable to seek care when they need it, who don’t fill their prescriptions, who delay their colonoscopies indefinitely or who keep smoking – regardless of the reason – place their own health at risk, waste human and material resources and incur unnecessary expense to themselves and others.

Given the current interest in the patient-centered medical home, from the provider community in particular, we offer two modest proposals for how the idea of patient-centeredness can extend to supporting patients’ needs to participate positively in their own care.