ACP and SGIM find the PCMH model aligns with principles of medical ethics and professionalism

The American College of Physicians (ACP) and the Society of General Internal Medicine (SGIM) explore the ethical dimensions of the patient-centered medical home (PCMH) in a new position paper published by the Journal of General Internal Medicine: "The Patient-Centered Medical Home: An Ethical Analysis of Principles and Practice." The text is also available on ACP's website.

"The PCMH model of care aligns well with the traditional principles of and professionalism, including the duty to promote the good and act in the best interest of the patient, the duty to do no harm to the patient, and respect for patient autonomy," said David L. Bronson, MD, FACP, president, ACP. "This position paper highlights some of the practical choices and implications of PCMH design and implementation that should be considered to ensure that this model of care becomes a key ingredient in better health care for patients."

In the paper, ACP and SGIM examine how the PCMH meets four fundamental ethical principles by facilitating:

  • a patient-centered approach to care, which reaffirms the core principles of medical ethics and professionalism
  • access to a personal physician who provides coordinated comprehensive care through an integrated team
  • involvement of patients, families, and caregivers in care, thereby supporting respect for patient wishes and autonomy
  • practice-based system improvement and explicit attention to quality
"The extent to which the practical implementation of the PCMH achieves ethical goals is likely to depend significantly on design features, such as the structure of and the measurement of and experience, quality of care and patient outcomes, cost of care, and further ," said Ann B. Nattinger, MD, MPH, president, SGIM.

Noting that many Americans are currently "medically homeless" and patients without access to care face a "perilous journey" as they try to navigate the health care system, the PCMH holds promise to substantively rectify this situation, bringing the system closer to the ideals of medical ethics and professionalism, ACP and SGIM say in the paper.

The organizations also note practical barriers to meeting some goals. For example, access to a personal physician responsible for coordination of care presents a challenge because of the shortage of primary care physicians.

ACP and SGIM say that the PCMH strongly supports the "bedrock principle" of because the concept of patient-centeredness that forms its foundation emphasizes patient engagement, provision of health information to patients, and involvement of patients in shared decision making.

By integrating system improvements into the practice environment, the PCMH could help physicians meet the ethical obligations for quality improvement and patient safety, ACP and SGIM say.

More information: http://www.acponline.org/running_practice/ethics/issues/policy/

Related Stories

Recommended for you

Increased morbidity, mortality in food system industries

date 2 hours ago

(HealthDay)—Occupational morbidity and mortality are elevated across food system industries compared with nonfood system industries, according to a study published online May 12 in the Journal of Occupational an ...

Three issues to consider before selecting EHR

date 3 hours ago

(HealthDay)—Work flow, features and functionality, and technical infrastructure should all be considered in advance of selecting an electronic heath record (EHR) system, according to an article published ...

Research letter: Indoor tanning rates drop among US adults

date 4 hours ago

Indoor tanning rates dropped among adults from 5.5 percent in 2010 to 4.2 percent in 2013, although an estimated 7.8 million women and 1.9 million men still engage in the practice, which has been linked to increased cancer ...

Stunting remains a challenge in South Africa

date 5 hours ago

Stunting remains stubbornly persistent in South Africa, despite economic growth, political and social transitions, and national nutritional programmes, says a Wits-led research team.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.