Who longs for the days of the family doctor having time to spend with you and actually listen to your issues? How about those home visits you remember as a child when you were too sick and the doctor actually came to your home? Those were the romantic days of family medicine and what many of us dream of when we sign up for medical school.
These days, thanks to corporations and insurance companies, the clinic has become a patient mill where patients see the doctors for 8 minutes to squeeze in their concerns. It isn't the doctor's choice to do this but they are owned by companies dictating their schedules. More and more insurance companies and especially Medicare are dictating medical choices and doctors have to choose the path of least resistance to survive so they give up the fight. The patients become the diabetic with the ulcer or the sickly kid instead of Mr. Johnson who has diabetes and suffering from an ulcer and little Jay who is having recurrent ear infections due to daycare. The person with multiples issues is dreaded and given time for one issue at a time when the issues are all really connected and should be considered as a whole.
Soon doctors will be graded on being compliant with what Medicare dictates. It sounds good on paper that we have a high percentage of patients with well controlled diabetes and blood pressure but the reality is that doctors are firing patients that are non compliant to improve their scores. It is mostly a subconscious thing I believe but still if I fire a patient for uncontrolled diabetes where do they go? I am the frontline in medicine. Maybe they only have $200 per month to eat and they can only afford cheap quality food? Maybe they are sharing their insulin with their husband because insulin is too expensive? Maybe the patient just isn't ready to change their diets? After all most of us have some bad habits and it is hard to change! So we are forced to have potentially worse scores and keep those patients who just don't want to change or we justify dismissing them for noncompliance. After all, we have tons more patients so we will help those who want help right? Terrible!
The Revolution
I can't take it anymore so now for the revolution! Well over 6,000 doctors nationwide are taking back our dreams of providing premium care to patients we love by the model of Direct Primary Care. The goal is higher quality and value care rather than volume. We eliminate the fee for service that creates a need for increased volume to be profitable and the patient feels like they need to squeeze everything out of that visit to get the most out of it. Neither create a system for focus on wellness. By having monthly payments to cover costs instead of depending on insurance and Medicare, patients can get care when needed and not worry about the additional cost. I will limit the number of patients to a panel of about 400 patients compared to 2000 that I had at a previous job so I have time to focus on getting our patients well with longer office visits, home visits, hospital visits (although we don't admit) and we won't be limited by the insurance companies and Medicare. Some things may be managed by phone instead of having to come in to be seen. In a regular model we only get paid if you are seen even if it is for minor things. Basic labs, paps, skin procedures, phone visits, office visits, and more are covered by the monthly fees and they will see me and call me! No more difficulties getting to talk to the actual doctor! I finally get to be that country doctor I dreamed of and now I have the integrative medicine on top of it so I can provide holistic medicine to the average person to get to the root of illness to create true wellness. I will be opened Benton Integrative Primary Care in July at the Acupuncture and Healing Arts building in Denver, NC and we grew so quickly that we had to move to Huntersville where we expanded and then opened a second location in Costwald. Check out www.bentonintegrative.com for details
My dream ultimately is to build a clinic that has a teaching kitchen with a health coach to teach people how to grocery shop and cook. I want a yoga/exercise room and classroom to teach people how to live more healthfully. I hope to have an IV therapy room so instead of going to an expensive ER or infusion center for a $5 bag of fluids, we can do it and get better faster and cheaper. I will have a full integrative team of health care providers to tap into all kinds of modalities to get better in the healthiest way possible. My goal is to treat the whole patient-mind, body, and spirit and partner with them to create wellness.
I have to make a shout out for Catawba Valley Medical Group where I worked prior to opening Benton Integrative because it is a real not for profit community hospital and is really great minus me having to see more patients than I really want to but it is reasonable compared to most clinics these days. They also really care about patients and have awesome providers. I have nothing but gratitude for them. Most "not for profits" manage to meet that criteria only through loop holes but practice as for profit and the well being of the patient really doesn't matter. These community centers and DPC clinics are making the medical system a better place for patients to seek care.