Fort Bragg community-based primary care clinics set to revolutionize health care

By Amber Avalona/ParaglideJanuary 7, 2011

FORT BRAGG, N.C. - "Welcome home to Family medicine," is the calling card for Fort Bragg's community-based medical homes, set to open in Fayetteville and Hope Mills by the first week of March.

The concept hails to simpler times of Family doctors who knew children by name and understood the medical needs of each patient. It also relates to the Army chief of staff's directive to improve access to care, which includes opening clinics within the community and bringing health care to the Families rather than requiring them to commute to post for wellness appointments.

According to Lt. Gen. Eric Schoomaker, U.S. Army surgeon general, "Community based primary care clinics are our first major initiative to implement patient-centered medical homes across the Army."

Fort Bragg chose two community sites based on geographic concentration of Families, unmet medical demand and projected population growth. Fayetteville Medical Home at the Woodland Office Complex (2350 Bentridge Lane, Fayetteville 28314), serving zip codes 28314 and 28376, will care for the same number of active-duty dependants as its partner location, the Hope Mills Medical Home at Millstone Town Center (3351 South Peak Drive, Hope Mills 28348), which hosts zip codes 28306, 28348, 28371, 28357, 28384 and 28386. Both clinics accept Family members from the zip codes of 28304, 28331 and 28309. A future Linden Oaks location is also under consideration.

The community clinics are set to offer full-service Family medicine, just like Fort Bragg health clinics. Routine, wellness and acute visits are available for Family members who need physicals, wellness exams, minor procedures or acute illness care. The two community-based, primary care clinics look and operate much like each other, in keeping with standardized business practices. Essentially, they are part of a new franchise model of community clinics, developed and managed by the Army.

Fort Bragg clinics currently serve an average of 119,700 patients annually (active duty and Family members). By opening the Fayetteville and Hope Mills clinics, the Army will care for 16,200 of these Family members. Each clinic employs a civilian staff of 35 medical professionals, including Family physicians, licensed practical nurses, laboratory technicians, psychologists and pharmacists. In keeping with the idea of consistency, the Army designed an all-civilian staff to remove "wild cards" like juggling deployments and temporary duty.

Col. Niel Johnson, deputy chief for the Department of Family Medicine and director of the community-based primary clinics, explained the value in creating patient-centered medical homes.

"(We have) teams of providers whose sole professional responsibilities are to their clinic patients, unencumbered by other missions, permanent change of stations or deployments," he said.

Enrollment in either clinic is voluntary, meaning patients can continue to receive care at an on-post clinic or switch to the newest community location.

"The healthcare team develops a comprehensive care plan as soon as the patient enrolls and then proactively engages the patient as a partner in their care," Johnson said.

Beginning in January, Family members enroll by visiting the Tricare Service Center, located on the first floor of Womack Army Medical Center. Health benefits remain the same, with only a change in location affecting the patients. In keeping with the needs of the Army, all servicemembers will remain with on-post providers who service pre- and re-deployment health exams or concerns.

The process of scheduling an appointment remains the same. On-post schedulers handle all phone calls, using the 907-2778 number. Patients also have the option of online scheduling via Tricare Online. Community clinics schedule follow-up appointments or necessary lab work.

For many Family members, the idea of a personal provider can be appealing, especially in a system where transition is the norm. The Fayetteville and Hope Mills clinics join a list of 17 community-based sites that are now run by Army installations. Johnson cited similar successes in places like Forts Sill, Stewart and Campbell and emphasized the benefits of this form of Family medicine.

"The more I get to know you (as a provider), the more we interact, the easier it is. There's less anxiety. You're more willing to follow through on my recommendations if you've developed a trust with me, as opposed to if you see somebody brand new every time.

The medical home model is the model where we treat every patient who's coming in as part of our Family," Johnson said.