Learning from Alma Ata: the medical home and comprehensive primary health care.

The patient-centered medical home (PCMH) recently has received much attention in health systems literature. The PCMH holds considerable promise for improving health outcomes and re-establishing a role for family medicine in a fragmented health care system. Despite its philosophical approach to comprehensive health care reform, the PCMH fails to offer concrete recommendations to address the social determinants of health, which include health and social policy. Political engagement to promote health is part of both primary health care and specifically family medicine's history; the absence of practical, adaptable ways to implement this engagement may undermine the PCMH's ultimate goals of improving individual and population health.