A Country Doctor

On May 29, 2011, Liane Hansen had a follow-up visit with Dr. Loxtercamp. http://www.npr.org/2011/05/29/136765...country-doctor

During the interview, Dr. Loxtercamp tells us:

Dr. LOXTERCAMP: Well, the most important thing I want to communicate is that medicine in America is really on the verge of a great sea change. And I want to talk about that from the point of view of someone who has seen the old general practitioner - my father and his contemporaries - who has seen my early practice. I saw patients in my exam room, I saw patients at the hospital, I visited them in the nursing home, I went to their homes, but it was really the doctor-patient relationship that I focused on.

Now we're at a point where that model doesn't work very well anymore. Society has changed, medicine has changed and primary care is adjusting to that change. I want to tell the story of how we came to be where we are through the lives of my father and a couple of his colleagues, through my own beginnings in the community of Belfast. And finally through my participation in some early experiments and the change that we foresee - the patient-centered medical home.

HANSEN: What's a patient-centered medical home?

Dr. LOXTERCAMP: It's an old term, actually. It began in the discipline of pediatrics for special needs children. But it's been rehabbed, promoted and marketed, and reconfigured to be a kind of practice that takes into account the need for patients to be seen by a doctor when they need to be seen, on the day they need to be seen, on the day they call in; to extend office hours, to make ourselves available regardless of the patient's finances, cultural barriers, transportation needs; and certainly what used to be the absence of acute-care visit openings in our practice.

So we've restructured our practice now to have open access, that when a patient calls, we have enough openings in the day to see them that day for what they need. So this is one component of the patient-centered medical home.

A second component is communication. And I think the most visible aspect of that component is the electronic health record. And I focus on communication as the greatest asset of the EHR, because it can be shared, not just with other people in my office, but with colleagues at the hospital or consultants that I send my patients to. And even now with patients, they can have access to their electronic health record from home, just the same way that I can for my home.

I used to think that this was not very important to patients. But when we first introduced this a couple of years ago, patients signed up for it in droves. And so it's very, very exciting that now there are two sets of eyes, two sets of invested parties looking over this record that I've created for the patient's behalf.

John F. Greden, M.D., the Director of the University of Michigan Depression, Center pays tribute to Dr. Loxtercamp by paraphrasing his words: “The foundation of medicine is friendship, conversation and hope.” Dr. Greden reflects on some of Dr. Loxtercamp's aphorisms, which he describes as "... statements [that] radiate truths about preventing and treating depressive illness. http://www.depressioncenter.org/director/

Doctors are easy targets. There are many good ones.