In the early 1990s, as the American Academy of Pediatrics was defining its vision of the “medical home,” a prototype was already in development at Minot Air Force Base in North Dakota. This care model was founded on interdisciplinary cooperation, family involvement, and coordinated services—components that characterize the medical home today, although at that time, it was more about survival than an acknowledged framework.
The idea did not arise from dreams but out of necessity, fueled by military logistics, rural seclusion, and a moral obligation to support children with intricate needs. This evolving story occurred alongside but remained unrecognized in the official account of the medical home concept.
Dr. Calvin Sia is acknowledged for promoting the medical home model since the 1970s, and in 1992, the AAP structured it formally. However, by the time this formal recognition occurred, the core of the medical home had already been actualized in Minot.
At Minot, Dr. Ronald L. Lindsay, motivated by his experience at Yale’s Child Study Center, created a new direction. Upon his arrival, he observed that well-child visit forms lacked developmental milestones. He initiated changes to incorporate the “Key Denver items,” and these adjustments were vital. A significant event was the early identification of acquired hypothyroidism in a six-month-old boy, a result of proactive screening and collaboration with specialists.
When Dr. Lindsay took the helm of the pediatric clinic in 1988, he instituted a cohesive care model rooted in continuity and interdisciplinary collaboration, with a focus on family partnership. He established a framework where Children with Special Health Care Needs received consistent and thorough care. This framework involved both civilian and military providers, achieving a functional medical home years ahead of its formal recognition by the AAP.
By 1990, Dr. Lindsay’s efforts earned him the Air Force Commendation Medal. His guidance and creativity transformed the pediatric clinic into a model of development and cooperation, featuring visits from leading consultants and specialists.
Despite his accomplishments, when the chance arose on a national stage in 1996, Dr. Lindsay found himself in the background. The institutional framework initially failed to acknowledge his contributions as fundamental to the medical home concept. Nevertheless, the Maternal and Child Health Bureau (MCHB) identified the system he created as a model, inviting him to enhance the LEND program.
Dr. Lindsay did not linger for recognition. Instead, he cemented his legacy through ongoing leadership, eventually revitalizing the LEND program at Ohio State University in 2009. His efforts continue to stand as a testament to the practical realities and transformative capabilities of the medical home long before it received its official designation.