Future vision: is family medicine ready for patient-directed care?

A growing number of Americans will soon have a Web-based personal medical home with connectedness to their chosen providers of care. The personal health record will become integrated with the electronic health record. Like other services on the Internet, patients will be able to direct much of their health care using clinical guidelines, such as prevention, chronic illness care, behavior change, and arrangement for minor acute care. Physician control and autonomy will give way to greater patient control over their care, a major culture change in medicine away from paternalism. While the personal family physician will continue as a primary caregiver, there will be a shift toward greater patient involvement in the coordination of care. Family medicine educators should begin now to educate medical students and residents for this new model of care.