Ask the Pediatrician: What is a medical home?
Medical health professions use the term “medical home” to describe the partnership between you, your child and your child’s medical team. It is not a house, an office or a hospital, but a plan to care for a child, keeping in mind all aspects of their health, including their family’s wellness.
The American Academy of Pediatrics recommends that care for babies, kids, teens and young adults should include a health care team. The partnership between you and your child’s team, based on trust and collaboration, should be the heart of their medical home. Through this partnership, you can access special care from other doctors. You can also organize when and how you get that care. Finally, you can access education services, home care, family support and other community resources that are important for your child’s well-being. When your health care team works this way, they make care accessible for you and your child.
Ideally, the same team should care for a child over the years and work with their family. Together, they should plan for transitions to other pediatric providers or into the adult health care system. When the same team works together over the years, they make sure the care they give the child is continuous.
Medical care should cover all aspects of a child’s well-being. The medical home should not only include the primary doctor. It should also include dietitians, nurses, mental and behavioral health professionals and care coordination providers. Care for a child’s wellness goes beyond acute illnesses or caring for medical needs when there is a chronic health condition. It includes preventative screenings, growth and nutrition assessments, developmental evaluations and health surveillance, alongside patient and parent counseling about topics such as nutrition, safety, parenting and mental health. When your care team covers all aspects of your child’s health, they are giving them comprehensive health care.
Whole child plans need to focus on what the child and the family need to be healthy, as well as their individual situation. Medical homes do this by engaging families in care planning as well as bringing the medical expertise needed for the child’s individual needs. It’s important to adapt plans to the family’s culture. When medical homes reflect the communities they serve and promote that all families have access to health care, they are family-centered and culturally effective.
The medical team should respond with empathy to the child’s and family’s needs or concerns. They should use them to propose care plans. Then, the medical team should decide with the family through shared decision making what those plans will look like before putting them into action. When your medical team shows compassion when it listens to your needs carefully and uses them to design a care plan for your child with you, the care they provide is compassionate.
All pediatric care providers, including community service providers inside or outside the medical home, should work together to create plans in partnership with the child and family. When your medical team partners with you and external medical professionals to make sure your child gets the care they need, they are showing they can give you coordinated care.
These are the core aspects of a medical home: a model of care for all children that is accessible, continuous, comprehensive, family-centered, culturally effective, compassionate and coordinated through a partnership with your child’s medical team.
Your child’s medical home provider should be well-trained to partner with your child and family, identify and take care of the unique wellness needs your child and family have, and help create a “medical neighborhood,” with the medical home at the center.
Children can get medical care in a number of places: a pediatrician’s office, a hospital outpatient clinic, a community health center or a school-based clinic. Often the medical home is a child’s primary care team, but for some children with chronic medical conditions, it might be a specialist. Any of those places can be part of a medical home, as long as the care children get there has the core components of a medical home.
The most important part of the medical home is a care team you know and trust and who knows and trusts you. When a health care relationship is built on mutual trust and common goals of a child’s well-being, it turns routine medical visit into a powerful partnership with the benefit of better health and wellness for your child and your family.
• Kristina E. Malik, MD, FAAP, is a certified pediatrician. She works at the Special Care Clinic in the Children’s Hospital Colorado. She provides comprehensive care for children with disabilities and difficult health conditions. She is also an Associate Professor of Pediatrics at the University of Colorado Anschutz School of Medicine. Dr. Malik is a member of the AAP Section on Home Care and a co-author of the Medical Home policy for AAP.
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