The Eight “C’s” of Success for Home-Based Primary Care
Dr. Paul Chiang, Senior Medical and Practice Advisor for the Home Centered Care Institute (HCCI), has made over 35,000 house calls. With that background, he recognizes that house call providers are – and should be – a different breed. That’s where his “Eight C’s” come in. They don’t address treatment options. They don’t even mention billing or insurance. They’re all about patient connection and care.
The idea, he said, was sparked by the HCCI logo. “I was in the HCCI boardroom many years ago,” he said, and the logo with the C’s in the middle leapt out at him. He said he mused: “How can I come up with some characteristic of a house call provider that uses those C’s?”
“What does it take to do this job well?” Dr. Chiang asked himself. “What are some of the characteristics (of a good provider)? What are the challenges? This is not hospital work. This is not the office. This is a unique way in which to deliver medical care. What set of skills does a provider need to pull this off in a competent, enjoyable way?”
And so, the “8 C’s” were born. Though the list is deceptively simple, the explanations are thought-provoking. Dr. Chiang calls them the “personality traits” of a successful HBPC care provider:
Dr. Paul Chiang
Competent with Complexity: Providers should be comfortable caring for patients with complex medical conditions, extensive medication lists, multiple labs, and diagnostic testing needs, as well as psychosocial complications and challenging family dynamics.
Communicate Comprehensively: Caring for patients in the home not only involves caring for multiple medical problems but caring for the needs of others involved in their care (such as caregivers and family members). It also includes a strong focus on end-of-life and goals-of-care conversations. Providers should be skillful communicators to assist with discussions on medical care and treatment with patients/caregivers, and other professionals involved in caring for their patients.
Character and Composure: HBPC providers often work alone and deliver care in the patient’s home setting. Providers should have the highest integrity to provide safe and quality care for the patient and reinforce the public image of this type of care for the field. Provider composure is essential as the scenarios encountered at home may be challenging both medically and socially. “This can be a lonely job,” Chiang adds. “In a brick-and-mortar setting, you have the all the resources to call upon. A house call provider often faces these challenges alone.”
Charm and Charisma: HBPC providers are in a unique position where the patient is not in the provider’s office; the provider is in the patient’s Understanding and being respectful of this privilege is important. Provider charisma can help guide the patient and family through difficult times as well as inspire others to consider the importance of this model of care.
A house call provider’s task is different from any other. And it comes with this unique perspective: “I want providers to know that it’s an honor and privilege to be allowed into a patient’s home,” Chiang said. “You’ve been given the opportunity to enter into a person’s life. That should never be taken lightly.”
For more information about HCCI’s educational, consulting and research services available to help providers and practices offer home-based primary care, visit www.hccinstitute.org.
To see what a house call looks and feels like, watch HCCI’s Rethinking Modern Medicine video with Dr. Chiang.