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The Patient-Centered Medical Home Neighbor: A Subspecialty Physician's View

Hal F. Yee Jr., MD, PhD
[+] Article, Author, and Disclosure Information

From the University of California, San Francisco; San Francisco General Hospital and Trauma Center; and Center for Innovation in Access and Quality, San Francisco, California.

Grant Support: In part by the William and Mary Ann Rice Memorial Distinguished Professorship and grants from the Kaiser Permanente Foundation, California Center for Connected Health, and California Health Care Foundation.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-2526.

Requests for Single Reprints: Hal F. Yee Jr., MD, PhD, San Francisco General Hospital, 1001 Potrero Avenue, NH 3D7, University of California, San Francisco, Department of Medicine, Box 0862, San Francisco, CA 94110; e-mail, hyee@medsfgh.ucsf.edu.

Author Contributions: Conception and design: H.F. Yee.

Drafting of the article: H.F. Yee.

Critical revision for important intellectual content: H.F. Yee.

Final approval of the article: H.F. Yee.

Administrative, technical, or logistic support: H.F. Yee.

Ann Intern Med. 2011;154(1):63-64. doi:10.7326/0003-4819-154-1-201101040-00011
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To achieve the benefits of the patient-centered medical home (PCMH) model, the American College of Physicians has issued a policy paper addressing the relationship between specialist and subspecialist physicians and PCMH practices. This paper represents a significant step toward improving care coordination and quality by demonstrating that this model is supported by numerous specialties and subspecialties, recognizing the importance of building a strong medical neighborhood, and providing a framework that will foster improvements in care at the interface of PCMHs and PCMH neighbors (PCMH-Ns). Construction of a well-functioning medical neighborhood will, however, require some refinements. First, the proposed interaction typology between PCMHs and PCMH-Ns must be expanded to include innovative forms of interaction that do not depend on traditional office visits, but for which there are clear incentives. Second, the recommended care coordination agreements must be better standardized for the sake of practicality. Finally, genuine dialogue between PCMH and PCMH-N practices needs to be realized.


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