If you’ve filled out a school health form, a camp physical, or a specialist referral in the last few years, you’ve probably come across a box asking about your child’s “medical home.” Most parents write in their pediatrician’s name and keep going. Some assume it means house calls. Others figure it’s insurance language for whoever is listed as the primary doctor.
It’s neither. “Medical home” is a specific standard from the American Academy of Pediatrics, it’s been around since 1967, and it describes something most families want badly without ever having a word for it. Let’s unpack where the term came from, the seven characteristics the AAP uses to define it, how to tell whether your child already has one, and how our own practice measures up, including the one place where we don’t.
(And no, it doesn’t mean the doctor comes to your house. Although for newborns, we actually do.)
Where Does the Term Come From?
The AAP introduced the idea in 1967, and at the time it meant something small and practical: a central location for a child’s medical records. The concern was children with special health care needs, whose charts were scattered across specialists, hospitals, and therapists, with no single place holding the whole story. If you’ve ever repeated your child’s history for the fourth time in a month to a fourth person who should already have it, you understand the problem they were trying to solve.
Over the next few decades the definition grew from a filing problem into a philosophy of care. The AAP published an expanded policy statement in 2002, and has built on it since through policies on family-centered care, care coordination, and how medical homes should be paid for.
Here is the sentence from that statement that explains the concept the best:
“A medical home is not a building or a place—it is an approach to providing comprehensive and high-quality primary care with a focus on building and developing partnerships with families, pediatric clinicians, early childhood professionals, community organizations, educational systems and other key agencies within the system of care.”
The question isn’t where your child gets care. It’s whether anyone is holding the whole picture.
The 7 Characteristics of a Medical Home
The AAP defines a medical home with seven characteristics. These are the Academy’s own words:
- Accessible – “Care is easy for the child and family to obtain, including geographic access and insurance accommodation.”
- Family-centered – “The family is recognized and acknowledged as the primary caregiver and support for the child, ensuring that all medical decisions are made in true partnership with the family.”
- Continuous – “The same primary care clinician cares for the child from infancy through young adulthood, providing assistance and support to transition to adult care.”
- Comprehensive – “Preventive, primary and specialty care are provided to the child and family.”
- Coordinated – “A care plan is created in partnership with the family and communicated with all health care clinicians and necessary community agencies and organizations.”
- Compassionate – “Genuine concern for the well-being of a child and family are emphasized and addressed.”
- Culturally Effective – “The family and child’s culture, language, beliefs and traditions are recognized, valued and respected.”
Seven is a lot to remember, so here’s a shortcut: five of them start with C. Continuous, Comprehensive, Coordinated, Compassionate, Culturally Effective. Add Accessible and Family-Centered and you’ve got the whole list.
And here’s the plain-English version to bring to your next visit. A medical home means your family can get in when you need to, the doctor knows your child by name and by history, somebody is keeping track of the specialists, and you leave feeling like a partner rather than an appointment slot.
Does Your Child Already Have One?
This checklist works on any practice, ours included. Think back over the last year of your child’s care.
- When your child was sick on a Tuesday morning, could you get seen that day, by someone who knew them?
- Does your child see the same doctor at most visits, or whoever happens to be available?
- After a specialist appointment, did your pediatrician know what happened without you having to relay it?
- Have you left a visit with a question you never got to ask?
- When you had a worried question at 9pm, was there a person to ask? Or a triage line that told you to go to the emergency room?
- Does your doctor know anything about your family beyond the chart; who’s at home, what your work schedule looks like, what’s actually keeping you up at night?
- The last time you disagreed or wanted to slow down on a decision, did that land as a conversation, or as a problem?
Answering “no” to a few of these is completely normal, and it usually isn’t a reflection of your pediatrician. But if you’re answering no to most of them, that’s worth paying attention to.
Why This Is Harder Than It Sounds
In a typical insurance-based practice, one pediatrician is responsible for somewhere between 1,000 and 1,800 children. The visit is scheduled in minutes rather than in questions.
Dr. Jonathan Jassey spent nearly two decades in traditional pediatrics, including years at a Long Island group practice he helped build, before opening Concierge Pediatrics. He doesn’t blame the doctors.
“Medicine has gotten lost in the relationship building, as it should be. People feel like they’re another number.”
That’s the honest diagnosis. Excellent physicians work inside that structure every day and deliver excellent medicine. But being reliably accessible, continuous, and coordinated inside it is a math problem more than a character problem. Which matters, because it changes what the fix is. If the answer to most of those seven questions is no, a better doctor rarely solves it. A different structure usually does.
How Our Practice Measures Up
A quick note on language before we go through these. There’s no AAP certificate that declares a practice a medical home, and we’re not claiming one. What follows is a read of our own model against the Academy’s seven characteristics, including where we fall short.
Accessible
Same-day or next-day appointments. No waiting room. Direct texting with your child’s pediatrician, an actual doctor, not an answering service or a nurse line. Roughly 95% of how our families reach us is a text message.
Then there’s the Nonagon, a take-home telehealth device that lets your doctor examine ears, throat, heart, and lungs from wherever you happen to be. That last part is not a figure of speech. One of our families was mid-ocean on a cruise when their daughter woke up with a badly bulging ear infection. They sent video, we diagnosed it, and because we’d sent them off with an antibiotic in advance, she started treatment that morning without ever seeing a ship’s doctor. Another family landed in Japan and started going down one by one; we ran a viral panel before they flew, examined the rest of them from eight thousand miles away, and listened to hearts and lungs from Long Island.
“We can see you from anywhere on this planet.”
Now the part we want to make sure that is fully understood. The AAP’s definition of accessible also includes “insurance accommodation,” and that’s where we don’t meet the standard as written. We don’t bill insurance. The simplest way to think about us is as an out-of-network provider. Families pay a membership fee directly, and we can provide a superbill (an itemized statement with medical codes on it, up to the amount you paid for your membership) that you submit to your plan yourself.
What comes back varies enormously. One of our families paid $2,500 for the year and was reimbursed $1,800 of it. We will never promise you that, because it depends entirely on your plan and your deductible. What our team tells every family who asks is the same thing: call your insurance company, ask about out-of-network coverage, and get real numbers before you decide anything. Most people are surprised by what they find. Some run those numbers and decide this isn’t the right model for them, and that’s a fair conclusion to reach, we’d just rather you reach it before you join than after.
Family-Centered
“True partnership” is hard to build in twelve minutes. We schedule 60 minutes for checkups, 30 for sick visits, and 45 for mental health visits, with only your family in the office.
The contrast Dr. Jassey draws is with what he calls a doorknob doctor:
“Their hand is on the door waiting to leave, because they have to get into the next room. In a traditional office you’re getting maybe 15 minutes for a well visit and 7 minutes for a sick visit. There’s no time to go over people’s concerns, so you have to pick your top two or three questions. Which is ludicrous.”
If you’ve ever sat in an exam room silently ranking your worries while the doctor typed, you know exactly what he means. The second and third questions are usually the ones that mattered.
We also don’t double-book, which produces a small recurring joke around here. Families look around the empty office and say it must be a slow day. It isn’t. We’re fully booked. It’s just built that way on purpose.
Continuous
We cap how many families each doctor cares for, and that cap is the entire point of the model. It’s why your child sees the same pediatrician rather than whoever is on the schedule that day.
One clarification worth making, care at Concierge Pediatrics doesn’t stop at 18, and it doesn’t stop at graduation. We see patients into their late twenties. Our Essentials plan, at a little over $100 a month, was built partly for college students who are hours from home with a telehealth device in their dorm room, which happens to be the exact stretch of life where most families lose continuity and young adults quietly fall out of care altogether.
Comprehensive
Here is the thing Dr. Jassey brings up first, and it’s about being proactive instead of reactive.
In his old practice, there was a list taped to the wall of the room where the doctors wrote their notes. It catalogued which insurance plans wouldn’t cover a hearing test. Which ones wouldn’t cover an EKG. Which ones wouldn’t pay for a vision screen. You checked the list before you ordered anything, because nobody wanted to hand a family a surprise bill for a five-minute test.
“It was so ridiculous you couldn’t even remember half of it. Here, we don’t care about that. Everybody gets the same exact checkup.”
So every annual physical includes bloodwork (CBC, cholesterol, glucose), an EKG from age 6 on, and hearing, vision, and urine screening. A pediatric cardiologist reads the EKGs. Strep tests and cultures run in our own lab, where we keep a throat culture incubator.
Screening tests are boring right up until they aren’t. Years ago, on a routine kindergarten CBC, a finger prick, part of the standard checkup. Dr. Jassey picked up leukemia in a child who had no symptoms yet. He’s caught cardiac conditions on annual EKGs that led to heart surgery and to a permanent pacemaker, in kids who felt completely fine.
We also handle mental and behavioral health inside the practice rather than turning it into three more phone calls for you: ADHD, anxiety, depression, OCD, and autism, including medication management. We use pharmacogenetic testing, a DNA test that shows how a child’s body metabolizes different medications, so that starting a medication is less of a trial-and-error process. An allergist sees patients in our office twice a week and a sleep consultant comes monthly.
The AAP’s wording here includes specialty care, and we’re a primary care practice, so true specialty care happens through coordination rather than under our roof. You keep your health insurance for hospital care, specialists, and emergencies.
Coordinated
The AAP asks for a care plan built with the family and shared with every clinician involved. This is the piece that often falls apart for most families’, because the person doing the actual coordinating ends up being a parent, from memory, in a hallway, holding a phone.
Dr. Jassey has a football metaphor for it.
“You either have a provider who’s your quarterback, or a provider who’s your punter. The punter punts to a specialist for every minor complaint. Rash, go to the dermatologist. Cough for two weeks, go to the pulmonologist. A good general practitioner should be able to handle a lot of these things and we know our limits, too.”
When something does need a specialist, the difference is in what happens next. A family joined us not long ago after their six-year-old had a first seizure. Their emergency room visit had gone badly, nobody could reach a neurologist that night, and they were sent home with a follow-up appointment two weeks out with a neurologist in Westchester, which is nowhere near them. Dr. Jassey texted the pediatric neurologist he trusts while the family was still sitting in his office. He had an answer before they left, and they were seen right away.
Another family’s teenager ran a fever, on and off, for 28 straight days. For a stretch of that, lymphoma was on the table. Dr. Jassey called one of the country’s top infectious disease specialists, a department chair at a hospital here on Long Island, who came in to see them first thing the next morning.
It turned out to be mono. He was fine. But the mother said something afterward that has stuck with us, because it’s the most common thing we hear from families in their first year:
“I didn’t realize I needed it until I really needed it.”
Compassionate
Every practice on earth believes this about itself, which makes it close to worthless as a claim. So instead, here’s how Dr. Jassey describes what he’s actually going for:
“It’s almost like having an aunt or an uncle in your back pocket that you can reach out to whenever, for whatever.”
Robyn, who works with him every day, puts it a different way. Doctors usually feel like a separate species from parents, and he doesn’t. He feels like somebody you’d spend time with.
The practical version of this is that he wears a stethoscope cover that changes every week, there are seven different animals in rotation, and kids come in trying to guess and that he narrates whatever he “finds” in your child’s ear. Cartoon characters for the little ones, increasingly implausible food combinations for the school-aged. And the answer to sticker or lollipop is both.
Read our reviews. Talk to families in your neighborhood. Come meet a doctor before you decide anything. We’d rather you test this one than take our word for it.
Culturally Effective
This one asks that a family’s beliefs and traditions be recognized and respected, which is easy to nod along to and harder to practice. The clearest test we run into is vaccines.
We believe in the vaccine schedule, we say so directly, and we don’t write medical exemptions. But somewhere close to half of pediatric practices will dismiss a family that hesitates, and we think that’s the wrong call the AAP’s own Red Book says so too.
“You’re their trusted provider. Where are they going at that point?”
Most families who hesitate aren’t anti-vaccine. They want to move more slowly, for reasons that make sense to them. So we go one shot at a time if that’s what it takes. We keep talking. And over the years a good number of adamant no’s have become yes’s, which would not have happened if we’d shown them the door on day one.
That is what culturally effective care actually looks like in practice. Not agreeing with a family about everything. Staying their doctor while you work it out.
When to Bring This Up With Your Pediatrician
You do not need to switch practices to ask for a stronger medical home. If your current pediatrician is a good clinical fit, it’s completely reasonable to ask whether you can be scheduled with the same doctor each time, how after-hours questions are handled, and who’s responsible for tracking specialist notes. Practices can often accommodate more than families think to ask for.
Pay closer attention to all of this if:
- Your child has a chronic condition like asthma, allergies, ADHD, anxiety, or a developmental diagnosis
- Your child sees two or more specialists
- You’re in the newborn or infant stage, when the questions come fast and constantly
- Your child is getting ready to transition to adult care
- You’ve moved recently, or changed practices more than once in a few years
- You’ve walked out of visits feeling rushed, unheard, or unsure what happens next
For children with special health care needs especially, this isn’t a comfort question. Fragmented care is where things get missed, and the medical home standard exists in the first place because of those children.
Whichever Practice You Choose
The medical home is a standard you’re allowed to hold your child’s care to, and most parents have never been told it exists. Now you have the Academy’s own seven characteristics and a set of questions you can ask any pediatrician, including us.
Ask them. A good practice won’t mind the questions — and the answers will tell you a great deal.
Already a Concierge Pediatrics family? Text your doctor about any of this. That’s what the number is for.
Not yet? Call (855) 543-7337 or learn more about membership. We care for families from our offices in Roslyn, Woodbury, and Bellmore on Long Island, and Short Hills, New Jersey.












