The Departments of Pediatrics and Family Medicine at both Boston Medical Center (BMC) and the Boston University School of Medicine (BUSM) are moving forth with propositions regarding pediatric guidelines to be implemented into institutions framed by the patient centered medical home model (PCMH).
The recommending board — comprised of Arvin Garg, MD, MPH, assistant professor of pediatrics at BUSM and pediatrician at BMC; Barry Zuckerman, MD, professor of pediatrics at BUSM and a pediatrician at BMC; and Brian Jack, MD, chief and chair of family medicine at BMC and BUSM — listed the following actions as necessary to address the social context of patient care within the PCMH scaffolding and, therein, reduce socioeconomic disparities in healthcare:
- Make social determinants of health an important aspect of clinical guidelines.
- Screen for particular social determinants at medical visits.
- Help patients and families access community-based resources, job training and food pantries.
- Implement "outside the box" multidisciplinary primary care interventions, such as programs like Reach out and Read, the Medical-Legal Partnership and Health Leads (developed at BMC).
- Integrate home visiting programs to better understand living conditions.
"Overall, implementing social determinants of health within the PCMH model will potentially reduce socioeconomic disparities in health that continue to exist today and ultimately improve the healthcare system, especially for PCMH's that serve low-income patient populations," the authors wrote.
The paper authors go on to note the adaptability of the suggestions to adult and elderly patient demographics, as well as the opportunities present for physicians within the PCMH sector (“a PCMH model allows for physicians to play a role in examining the social determinants of health in order to assess and treat patients with a more holistic approach and improve population health”).
The article was published in the latest edition of the Journal of the American Medical Association.