title: Maximizing the Patient-Centered Medical Home (PCMH) by Choosing Words Wisely.
abstract: BACKGROUND
  Culture is transmitted through language and reflects a group's values, yet much of the current language used to describe the new patient-centered medical home (PCMH) is a carryover from the traditional, physician-centric model of care. This language creates a subtle yet powerful force that can perpetuate the status quo, despite transformation efforts. This article describes new terminology that some innovative primary care practices are using to support the transformational culture of the PCMH.
  
  
  METHODS
  Data come from the Agency for Healthcare Research and Quality-funded Working Conference for PCMH Innovation 2013, which convened 10 innovative practices and interdisciplinary content experts to discuss innovative practice redesign. Session and interview transcripts were analyzed using a grounded theory approach to identify patterns and explore their significance.
  
  
  RESULTS
  Language innovations are used by 5 practices. Carefully selected terms facilitate creative reimagining of traditional roles and spaces through connotations that highlight practice goals. Participants felt that the language used was important for reinforcing substantive changes.
  
  
  CONCLUSIONS
  Reworking well-established vernacular requires openness to change. True transformation does not, however, occur through a simple relabeling of old concepts. New terminology must represent values to which practices genuinely aspire, although caution is advised when using language to support cultural and clinical change.
authors.affiliation: From the Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Somerset, NJ (JH, BFC); the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond (RSE); the Department of General Medicine, Ambulatory Practice of the Future, Massachusetts General Hospital, Boston (JBC); the Department of Social Medicine, Heritage College of Osteopathic Medicine, Dublin, Ohio University, Dublin (DS); the Research Institute at Nationwide Children's Hospital, Columbus, OH (KJK); and the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM). jenna.howard@rutgers.edu.
authors.forename: Jenna
authors.initials: J
authors.lastname: Howard
authors.affiliation: From the Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Somerset, NJ (JH, BFC); the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond (RSE); the Department of General Medicine, Ambulatory Practice of the Future, Massachusetts General Hospital, Boston (JBC); the Department of Social Medicine, Heritage College of Osteopathic Medicine, Dublin, Ohio University, Dublin (DS); the Research Institute at Nationwide Children's Hospital, Columbus, OH (KJK); and the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM).
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Etz
authors.affiliation: From the Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Somerset, NJ (JH, BFC); the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond (RSE); the Department of General Medicine, Ambulatory Practice of the Future, Massachusetts General Hospital, Boston (JBC); the Department of Social Medicine, Heritage College of Osteopathic Medicine, Dublin, Ohio University, Dublin (DS); the Research Institute at Nationwide Children's Hospital, Columbus, OH (KJK); and the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM).
authors.forename: J Benjamin
authors.initials: JB
authors.lastname: Crocker
authors.affiliation: From the Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Somerset, NJ (JH, BFC); the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond (RSE); the Department of General Medicine, Ambulatory Practice of the Future, Massachusetts General Hospital, Boston (JBC); the Department of Social Medicine, Heritage College of Osteopathic Medicine, Dublin, Ohio University, Dublin (DS); the Research Institute at Nationwide Children's Hospital, Columbus, OH (KJK); and the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM).
authors.forename: Daniel
authors.initials: D
authors.lastname: Skinner
authors.affiliation: From the Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Somerset, NJ (JH, BFC); the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond (RSE); the Department of General Medicine, Ambulatory Practice of the Future, Massachusetts General Hospital, Boston (JBC); the Department of Social Medicine, Heritage College of Osteopathic Medicine, Dublin, Ohio University, Dublin (DS); the Research Institute at Nationwide Children's Hospital, Columbus, OH (KJK); and the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM).
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Kelleher
authors.affiliation: From the Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Somerset, NJ (JH, BFC); the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond (RSE); the Department of General Medicine, Ambulatory Practice of the Future, Massachusetts General Hospital, Boston (JBC); the Department of Social Medicine, Heritage College of Osteopathic Medicine, Dublin, Ohio University, Dublin (DS); the Research Institute at Nationwide Children's Hospital, Columbus, OH (KJK); and the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM).
authors.forename: Karissa A
authors.initials: KA
authors.lastname: Hahn
authors.affiliation: From the Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Somerset, NJ (JH, BFC); the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond (RSE); the Department of General Medicine, Ambulatory Practice of the Future, Massachusetts General Hospital, Boston (JBC); the Department of Social Medicine, Heritage College of Osteopathic Medicine, Dublin, Ohio University, Dublin (DS); the Research Institute at Nationwide Children's Hospital, Columbus, OH (KJK); and the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM).
authors.forename: William L
authors.initials: WL
authors.lastname: Miller
authors.affiliation: From the Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Somerset, NJ (JH, BFC); the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond (RSE); the Department of General Medicine, Ambulatory Practice of the Future, Massachusetts General Hospital, Boston (JBC); the Department of Social Medicine, Heritage College of Osteopathic Medicine, Dublin, Ohio University, Dublin (DS); the Research Institute at Nationwide Children's Hospital, Columbus, OH (KJK); and the Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM).
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Crabtree
mesh_terms: D001291:Attitude of Health Personnel; D065246:Culturally Competent Care; D006801:Humans; D009936:Organizational Innovation; D018802:Patient-Centered Care / Q000379:methods*; D010820:Physicians; D011320:Primary Health Care / Q000379:methods*; D011787:Quality of Health Care; D009626:Terminology as Topic; D014481:United States
keywords: Health Care Systems; Patient-Centered Care; Primary Health Care; Qualitative Research