Growing numbers of primary care practices are embracing
the I. T.-intensive model of care delivery.
By Gary Baldwin
At a young age, Sal Volpe, M. D., became enam- ored of a well-known—but fictitious—family physician. “I grew up with Marcus Welby,” Vol- pe recalls. The late Robert Young played the TV character who was the kind of physician every- one dreams about: patient, concerned, with a
seemingly endless supply of time for each patient and possessing a
remarkable blend of medical knowledge and avuncular wisdom.
Decades later, the grown-up Volpe—who’s certified in pediat-
rics, geriatrics and internal medicine—is attempting to recreate
that type of doctor-patient relationship in his own solo practice in
Staten Island, N. Y.
There are a couple of key differences. Volpe documents his care
with an electronic health record, having abandoned the paper
charts ubiquitous during the Welby era. And unlike Welby, who
practiced in an era all but devoid of pre-authorizations, high de-
ductibles and insurance plan second-guessing, Volpe must con-
tend with the economic realities of modern medicine. That’s why
he has fashioned his practice around the “patient-centered medi-
cal home” model of care delivery. The model—in place at a grow-
ing number of primary care practices—attempts to temper the
volume-based mania of fee-for-service medicine with a preventive
approach designed to be more meaningful—and effective—for pa-
tients and physicians alike. The model can also reduce care costs,
which is why growing numbers of payers are incentivizing it.