Patient Medical Homes

Updated April 11, 2024.

Creating freedom for family doctors so they can do the work they love to do, and what brought them into the medical profession in the first place.

A patient medical home (PMH) is a family practice that operates at an ideal level to provide longitudinal patient care.

It is the foundation of care delivery within primary care networks (PCNs) in local communities—the cornerstone of an integrated system of primary care and community care.

A PMH in BC has 12 attributes that define how a practice can support patients, including through team-based care.

As an ideal family practice, a PMH enables family doctors to:

  • Work with primary care teams to support quality team-based patient care.
  • Use panel management to obtain accurate EMR data about their patient panels to provide proactive and preventative care.
  • Get support for patients from health care teams located in the community, and from networks of colleagues. Everyone can work to their strengths, and support and rely on each other to ensure patients get the best care.
  • Participate in primary care networks to access a broader system of services and supports in the community.

Within a PMH, physicians and/or nurse practitioners as the most responsible care provider play a central role in leading and coordinating patient care.

Other primary care clinics, such as a community health centre or health authority-run clinic can also function as a PMH.

For patients

Through a PMH, patients have greater access to continuous, comprehensive, and coordinated primary care.

For doctors

Within a PMH, family doctors can:

  • Increase their ability to provide optimal care for patients, and conveniently access a full range of supports and services for patients.
  • Spend more time on difficult diagnoses and strengthening patient relationships.
  • Reduce the burden of caring for patients alone, which can help to prevent burnout.
  • Increase the efficiency of the practice and streamline processes to maximize time, resources and capacity.


International model, adapted for BC

The PMH model is being implemented and tested around the world, which has given BC a chance to learn from what others have done.

The 12 attributes of a patient medical home in BC are based on the College of Family Physicians of Canada’s framework and pillars.

The FPSC has adapted the PMH model to recognize strong partnerships and networks that have been established through the divisions of family practice, health authorities and community partners. The provincial model also takes into account the collaborative partnership between the Government of BC and Doctors of BC, represented by the FPSC, that is unique to BC.

Research and Evidence


  • Patient Experience Tool
    An e-questionnaire that collects patients' perspectives on their visits to a family doctor's practice to help inform practice improvements.
  • Practice Support Program
    Access at-the-elbow coaching and services to help implement the attributes of a PMH.