Delegating a proportion of this care has the potential to create system-wide efficiencies by freeing up specialists to concentrate more on new patients and those with complex conditions.

"The cumulative time spent by specialists on routine chronic care is not trivial," says the study's senior author David C. Miller, M.D., M.P.H., an assistant professor of urology at the U-M Medical School.

"As a urologic oncologist, I take care of many cancer survivors. With a detailed care plan constructed by the treating oncologist, much of the follow-up care for these patients could potentially be assumed by a primary care physician-directed medical home, with appropriate referral back to me if problems or questions arise.

"This approach may have benefits for patients in terms of improving both coordination and access to care," Miller says.

Miller and several other study authors are affiliated with the Veteran's Affairs Ann Arbor Health Care System. The VA is one of two major federal departments that are moving toward implementing patient-center medical home reforms.

The medical home model also offers other potential benefits including less fragmentation of care, in which a patient's physicians aren't aware of what the others are doing; minimization of redundant tests and services; and more prestige and pay for primary care physicians, which may help entice more medical student to enter general medicine.

SOURCE University of Michigan Health System