Jerald Winakur’s Feb. 14 Sunday Opinion commentary, “Doctoring is a dying art,” was right to say that in today’s corporatized, professionally fragmented medical landscape it is almost impossible for a primary-care doctor to take the time to truly connect with patients and their families. I am blessed, however, to work in a setting that allows just that: the Veterans Health Administration.
As medical director of the Home Based Primary Care program at the Martinsburg (W.Va.) Medical Center, I oversee teams that provide care to frail patients in their homes. I have the time to hear their stories, know their family caretakers, perform a good physical exam and do a thorough chart review. Our typical patient is elderly and has multiple medical problems, which adds to the complexity of care.
Our electronic records system allows me to access patients’ prior medical records at any VA facility.
Such programs decrease hospitalizations and the length of stay for chronically ill patients, cutting the costs of inpatient care. Medicare recently began testing a similar initiative, the Independence at Home program, which, in the first year of a three-year pilot study, generated savings of $25 million.
Home-based primary-care programs can be a refuge where doctors, and their nurse-practitioner and physician-assistant colleagues, can practice traditional personalized medicine while enjoying the benefits of modern communications technology.
Milton D. Havron Jr., Winchester, Va.