The Medical Home

By Dr. Mary McAteer

Spirit & Place allows our community to explore one yearly theme through a variety of lenses. With this year’s theme being “home,” The Indiana Chapter of the American Academy of Pediatrics would like to take the opportunity to educate families about an aspect of home they might not be familiar with: the medical home.

The American Academy of Pediatrics (AAP) believes that the medical care of infants, children, and adolescents should be accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective. It should be delivered or directed by well-trained physicians who provide primary care and help to manage and facilitate all aspects of pediatric care. The physician should be known to the child and family, and should be able to develop a partnership of mutual responsibility and trust with them. These characteristics define the “medical home,” and stand in contrast to care provided through emergency departments, walk-in clinics, and other urgent-care facilities. Though such care is sometimes necessary, it is more costly and often less effective.

A medical home is not just a building or place – it extends beyond the walls of a clinical practice. A medical home builds partnerships with clinical specialists, families, and community resources. The medical home recognizes the family as a constant in a child’s life, and emphasizes partnership between health care professionals and families. A medical home is where everyone in the office knows your name when you call, welcomes you, and encourages your input. It is a place where your family’s priorities and traditions will be respected, and your child is able to express his feelings, even when it takes time. Further, if needed, a medical home helps you get connected to other health care professionals or community resources and stays with you through the journey.

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When you have the healthiest child on your block and your family is humming along in wellness, your medical home can help you with routine health screenings, safety information and sports physicals. There are many sources of information that are confusing and may not be rooted in solid science, and your doctor can help put new or controversial information into perspective. When a child goes to school and is not functioning in a given area, your doctor can help narrow down the concern and chart a course to assist you. If a tragedy befalls a family member, or a tragedy within the community hits a child especially hard, having a trusted professional to talk to may offer valuable support.

Where this model shines the brightest is with our children who have special health care needs. When a child receives care through multiple providers, or has more complex needs at school or at home, a medical home that provides a central location and oversight for all the child’s health needs and information can be a valuable asset. The concept of the medical home introduces a pediatrician’s voice into the conversation, and fosters relationships that allow a doctor to help advocate that while a child may need a special form of care, he or she is still capable of succeeding socially and academically.

Many people consider their home a place of comfort and security – a place where they can be open and honest and not feel threatened. That feeling should extend to your family’s doctor’s office. It should be a place you feel safe and secure, and a place where you feel comfortable enough to talk about anything that might be affecting the health of your family. A medical home, where you can establish a lifelong relationship with a team of care providers, is the ideal place to find this atmosphere.

INAAP is an organization of over 800 pediatricians throughout Indiana who are committed to improving children’s health through collaborating with each other, advocating for health care policies, and using dependable resources of science to disseminate good medical advice. We meet every month, discussing action items to improve children’s health care, writing articles, hosting medical meetings, and interfacing with lawmakers and other health policy experts. We work within the American Academy of Pediatrics, the originator of the medical home concept. For further resources, check out, or contact our Executive Director, Chris Weintraut at









A Woman’s Greatest Risk

Branyas_Nancy_Suit colBy Dr. Nancy Branyas, “Dr. Go Red”, St. Vincent Heart Center of Indiana

When people think about risks, dangerous activities often come to mind—skydiving, mountain climbing and whitewater rafting to name a few. But frequently, taking a big risk can be NOT doing something.

“Heart disease is the number one killer of women in the United States, affecting 43 million women each year.”

Not paying attention to your heart health is a major risk, especially for women.

In my role as “Dr. Go Red,” working with women at St.Vincent Heart Center of Indiana and the American Heart Association’s Go Red For Women movement, I share the message that heart disease is the greatest risk to a woman’s health.

Heart disease is the number one killer of women in the United States, affecting 43 million women each year, and it kills more women than all forms of cancer combined.

go-red-for-women-logoFortunately, there are lots of ways to mitigate this risk.

Making heart-healthy lifestyle decisions is the best way a woman can protect herself from heart disease. This means adhering to an exercise schedule of 30-60 minutes a day, eating a healthy diet low in saturated fats and replete with fruits and vegetables.  Smoking cessation is crucial. Tobacco alone can increase a woman’s risk for heart disease by as much as 400 percent.

Paying close attention to the signs of heart disease is another way women can significantly reduce their risk. The signs of heart disease in women are often different from those signs in men. While chest pain or chest heaviness and tightness is the classic presentation in both sexes, women can have other symptoms less common in men that include left shoulder or interscapular back pain, jaw pain, fatigue, sweating, nausea and worsening shortness of breath.

“African-American women are more predisposed to developing heart disease than Caucasian women.”

Getting regular health screenings is also critical to minimizing a woman’s risk for heart disease. These screenings include regular blood pressure tests, cholesterol level tests and diabetes screenings. Knowing your numbers is the first step to heart disease prevention. If your numbers aren’t optimal, your doctor will recommend intervention.

It’s important to remember that some women are at greater risk than others for developing heart disease. Ethnicity plays a role. African-American women are more predisposed to developing heart disease than Caucasian women. Family history and age are other important factors to consider. Diabetic women are at five times the risk of developing heart disease. But don’t forget that heart disease can strike any woman at any age.

In order to greatly diminish the chances of having heart disease, women must maintain a heart-healthy lifestyle, schedule regular health screenings and know the warnings signs. Just remember – if you take care of your heart, it will take care of you.

Risk can make life exciting. It can give you a fantastic rush. But when it comes to heart disease, taking a risk simply isn’t worth it.

Learn more about risk at the 18th annual Spirit & Place Festival November 1-10.

Dr. Nancy Branyas is a cardiologist/electrophysiologist with St.Vincent Heart Center of Indiana. She initiated the Women’s Cardiac Risk Clinic, designed to identify those women who have, or who are at risk for heart disease. As “Dr. Go Red,” she is the face of the American Heart Association’s Indianapolis Go Red For Women movement.

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