A Medical Home?

This is an historical post from an earlier blog, Adopted Son of the Autism Family, which I had before this current blog. It is re-posted without modification (other than this introductory sentence).
This may end up being a short post. My blog is pretty young, and I don’t get tons of comments, but I’d love to hear from you here or on Twitter or LinkedIn.
When I first came to Hope Network, there was a residual push for an extended idea like a medical home — that parents would want their child to receive primary care here at the Center, be seen by a dentist, maybe even get haircuts, all in addition to the main guard of autism diagnostic evaluation and therapeutic services.
How much should Autism care be “one stop shopping”?

I was (and still largely) am a little reluctant. My experience has been that the pediatricians who see our kids want to keep seeing our kids. They like our kids. They just know that they need more services than their office can offer. Likewise, I don’t really want to start an “autism school,” because I want to support our kids in thriving in our community schools (and, again, their teachers love them, and want to serve them, and they reluctantly give up time with them to let us give them a boost that will help them benefit more from school).

A big part of this is cultural – as a neuropsychologist, I am a specialist that lives off of referrals from other doctors. Typically, that would be neurologists, hematologists/oncologists, developmental pediatricians, transplant teams, and so on, but in the case of autism, that’s typically community pediatrics. Those physicians invariably see my service as part of their ongoing care of their patient. And I agree – I am glad to be of service (and the old fashioned, bowtie wearing specialist even writes that at the end of the report!). A well respected team I trained on at the University of Chicago used to compare anyone who deviated from this to Mordor in the Lord of the Rings – a pit of darkness from which escape is impossible.
However, the big other part, mission-wise, is that I want to empower families and transform communities so children with autism thrive. In their communities. Even if it would be easier, I do not want to set up a clinic with a one-way door into some alternate universe from which a child with autism can never escape, but never needs to, because all the services are offered under my roof.

There is probably room for some balance, though. If I ever got the time, I’d love to collaborate with the Aveda Institute in town to help kids who have trouble getting their haircut look fabulous, and also help train a new generation of stylists who won’t have any problem when a child with autism walks in their door. Part of me would like to have a physician presence in our clinic, and even in psychology and behaviorism, there are services we don’t provide today that I want to bring in house to make it easier on families.

What are your thoughts? How vertically integrated should autism care be? Would you like a one-stop-shopping experience, or would you like us to be more tightly integrated into the broader community, and function as a pit-stop or way-station along an integrative path?

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s