Innovative health care effort in Chicago reports successes and disappointments

Several news outlets look at different models for medical care.

"An initiative designed to transform health care on Chicago's South Side ... has linked 5,600 people to a 'medical home' since 2005, University of Chicago executives said Thursday," The Chicago Tribune reported. "Five years after the Urban Health Initiative was launched as a way to educate patients on the best use of the emergency room, the program has grown into a network of 25 community-based clinics and other medical care providers on a budget of more than $6 million a year. It is now poised to escalate research initiatives and teaching opportunities for physicians in hopes of becoming a national model for medical care in urban areas." But officials "acknowledge that these patients are not consistently maintaining a relationship with a doctor after they are guided by U. of C. to its vast network of primary care providers" (Japsen, 7/29).

Chicago Sun-Times: One of the big challenges for Chicago's Urban Health Initiative "has been getting people who schedule appointments through the U. of C. program to keep them. Since the initiative was launched in 2005 with help from first lady Michelle Obama, then U. of C.'s vice president for community and external affairs, only about 35 percent of the almost 16,000 appointments made as of January had been kept, hospital executives said Thursday" (Thomas, 7/30).

The Denver Post: Meanwhile, health care leaders met this week in Denver and heard that the "future of health care is a patient-centered system with one-stop shops for medical, mental and dental care, and health care teams to handle middle-of-the-night e-mails." But physicians are reluctant to move to such a system, experts said. "The setup of the future, where patients have 'medical homes,' will rely on doctors delegating more of their duties to nurses, physicians' assistants and other health care workers. Many doctors say they don't want to lose patients, yet they cannot become 'medical homes' with such heavy workloads. 'The physician can't be everything,' said John Rother, AARP's executive vice president of policy and strategy. 'It has to be about the team.'" Experts speaking at the conference urged states to "re-examine scope-of-practice and minimum-education laws that limit nurses and physicians' assistants" (Brown, 7/30).