The Patient-Centered Medical Home is a model of care – not a place – that allows your primary care provider to be the main person coordinating all of your care. Your primary care provider will communicate with other people – such as other doctors, pharmacists, and social workers – to help you get the care you need when you need it. Other team members may include:

  • Patient Service Specialist
    Works to answer your calls, schedule appointments, and take your messages and health concerns to clinical team members.
  • Clinical Staff
    Provides you care by discussing your medical concerns with you and works with provider to get you the care you need. Will prepare you for your appointment, provide you with education on conditions and illnesses, and works to assure you get the preventive care you need to stay well.
  • Care Coordinator
    Registered Nurse that works to take care of you following your stay at the hospital or other health care facility. Provides you with assistance in finding the community resources you may need or the education and tools for self-managing your conditions.
  • Referral Coordinator
    Available on some medical home teams. Works to set up any outside appointments with specialists or arrange for outpatient testing that’s been ordered by your provider.
  • Social Worker
    Helps manage patients with chronic physical and emotional health concerns to connect them with community resources. Assists with placement to nursing homes or mental health facilities. Also assists patients and families with substance abuse.

How we help you

  • Access
    We offer shorter wait times, afterhours care, and 24/7 access via telephone, email, or patient portal.
  • Comprehensive
    We get to know you and will be responsible for your health care needs.
  • Education
    We talk about your questions and explain all tests and procedures.
  • Coordination
    We help you schedule appointments and find resources for care.
  • Connection
    We will make sure that your care team is up to date.

How you help us

  • Work with us to set goals and plans that best meet your health care needs.
  • Tell us what medications you’re taking and about your health conditions, past and present.
  • If a plan isn’t working for you, tell us about it.
  • Tell us when you see another health care provider, like an urgent care facility or a new pharmacy, so we can add them to your care team. Our goal is to keep all team members informed.
  • Follow your health care plan and call us if you have questions.
  • Contact us if you have a health care concern that cannot wait. Even if you call when our office is closed, you will speak with an on-call provider who will help you.
  • Keep your appointments or reschedule if you can’t make it.

What happens after the office closes?

There is always a provider on call to help you. To reach an on-call provider, simply call the office phone number and connect to the answering service. The answering service will connect you with a health care provider. Summit Health has after-hour care centers located throughout the area to provide quick, effective treatment for minor illnesses and injuries. These facilities should be used so the emergency departments can focus on treating more serious conditions.