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A "Medical Home" On the Range for Rural Oregon

PHOTO: A lot is changing in the way healthcare is delivered in Oregon, with more clinics adopting the "medical home" model, a team approach to keeping people well. Photo credit: Deborah C. Smith.
PHOTO: A lot is changing in the way healthcare is delivered in Oregon, with more clinics adopting the "medical home" model, a team approach to keeping people well. Photo credit: Deborah C. Smith.
July 25, 2013

REEDSPORT, Ore. - Imagine a medical checkup that focuses on how you're doing instead of what's wrong.

A growing number of small-town health clinics in Oregon are reorganizing their practices to become "medical homes." Patients are able to call on a team, not just a doctor, for health questions and recommendations.

On the coast, some clinics in the Columbia Pacific Coordinated Care Organization have adopted the medical-home model. Mindy Stadtlander, a clinical systems innovation program manager for CareOregon, helped with the transition and said it's a more neighborly way to improve patient care.

"The provider and the team that takes care of them knows about them. They know their family, they know their history," she said. "They can call them in for visits when they haven't been in for a long time and they're needing some up-to-date prevention or other health screenings."

The focus in a medical home is on staying healthy and managing chronic conditions, explained Stadtlander, which also saves money, rather than waiting until a problem becomes serious to get care. The care team looks beyond a person's medical chart, sometimes recommending social services or community activities.

The medical-home model has built-in challenges in rural areas, where clinics are small and there's a shortage of providers.

Dr. Janet Patin, a family practitioner who moved from Ohio to Reedsport to be part of Oregon's health-care transformation, said she thinks other doctors would do the same.

"This is really exciting medicine - to be able to give people better care, the care that we know we can provide, that people deserve," said Patin, who practices at Dunes Family Health Care. "That's going to be a recruiting benefit. I think people are going to want to be part of that, as providers."

The biggest challenge isn't geography, she said; it's getting people to see the health-care system, and their role in it, differently.

"What we're trying to do," she said, "is shift patients' to thinking, 'I am the most important member of my health-care team,' you know. 'How can you help me be healthier?' You don't go to the doctor and say, 'Fix me.' "

Patin said small towns have one advantage in setting up medical homes, because the providers often are well acquainted with patients and their families.

Chris Thomas, Public News Service - OR