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Good health care shouldn’t start in emergency room

Good health care should begwith regular checkups. Emergency rooms are for back-up care when health fails.  |  Sun-Times

Good health care should begin with regular checkups. Emergency rooms are for back-up care when health fails. | Sun-Times file photo

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Updated: December 5, 2012 6:32AM

A good health-care system means getting the care we need, when we need it, where we need it.

And the care we provide every American citizen should not begin with desperate measures to remain alive in an emergency room after having a heart attack, as Mitt Romney suggested in a recent interview with “60 Minutes.”

The purpose of a health-care system should be to keep people well, with emergency rooms reserved for back-up care when health fails.

The care we need starts with regular checkups. A primary-care physician can treat hypertension before it ever becomes a matter of life or death.

I practice in the Chicago Family Health Center, a community health center that is affiliated with the University of Chicago Medicine through the South Side Healthcare Collaborative. When patients go to the emergency room for care that is better handled in a community health center, patient advocates let them know about the possibility to make my health center their medical home.

We have the social workers, psychologists, nutritionists, case managers and health educators that patients need for a comprehensive approach to staying healthy.

Patients can take tours of the grocery store with diabetes educators from the University of Chicago to learn about how to make healthy nutrition choices.

They can do yoga on Saturdays in the health center’s sunny atrium in our pay-what-you-can classes.

They can learn the lifestyle habits they need to stay well, while having access to the doctors and medications they need to treat their hypertension before the silent killer morphs into a full-blown heart attack.

Primary-care medical homes — community health centers or the clinics of internists, pediatricians and family physicians — are about promoting health.

Tertiary care centers — hospitals and their emergency rooms — are about preventing death.

Emergency rooms are expensive. They are not designed to provide cost-effective care to keep Americans healthy.

A healthier America won’t come from creating more emergency rooms.

It will come, instead, from ensuring that every American has access to a medical home, as provisions in the Affordable Care Act seek to ensure.

In a patient-centered medical home, we can focus on promoting health instead of fighting off death, shifting from our disease-care system to a true health-care system.

Dr. Kohar Jones is a family physician at the University of Chicago Medicine and director of community health and service learning.

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