The American dream for healthcare needs strong medicine.
The inscription on the Statue of Liberty which is taken from the poem New Colossus written by Emma Lazarus says in part,
Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tossed to me,
I lift my lamp beside the golden door!
Over the last several decades the medical economic model has encouraged physicians to seek out otherwise well and healthy patients. It was inadvertently done and without any malicious intent but the pressures were real. The system requires such enormous documentation and coding that it has encouraged patients to conform to the box in which they are placed. It discourages individualism in favor of protocols. It celebrates documentation of such things as smoking rates yet hinders the affordability of medication to stop smoking. The system wants to categorize and number patients and let them be a resource to run through it’s machine. When patients want to be individuals, freely making their own healthcare decisions, then the system runs poorly. Those individuals with complex and personal needs become burdensome to the system and often are subtlety shunned.
From it’s foundation Trinity has been principled in seeking to serve those who need care. These are “the tired, the poor and the huddled masses” to whom Ms. Liberty proclaims refuge. In this week of political celebration or protest (depending on your viewpoint), we want to again reiterate our stance on seeking to serve those who are sick and hurting. We stand ready to care for all patients of all conditions.
We do this in several ways. First our walk in clinic serves the community six days a week in a personal and compassionate manner. Our charges for services are some of the lowest in the area. We dumped the double standard charge model years ago where the uninsured paid substantially more than the insured. Today, anyone who is cared for in our practice will pay the same amount regardless of insurance status. For anyone who pays in full at the time of service, they will receive the same discount that has been negotiated by the the insurance companies. Everyone pays the same.
Second, our depth of resources for our patients to truly become healthy are unparalleled across the country let alone Knoxville. We offer a full range of experts to help patients treat, reverse, and cure their chronic illness with nutrition changes, exercise programs, wellness plans, stress management, sleep improvement, and Biblical counseling. We have seen patients reap large rewards of weight loss, medication reduction, and reclaiming their lives as they progress through the programs.
Lastly, our Direct Primary Care program is offering discounts to new patients with chronic conditions. Any new patient that completes their first member appointment with the Direct Primary Care program by the end of Inauguration Day and has one of the three biggest chronic, pre-existing conditions of diabetes, high blood pressure, or high cholesterol for which they are receiving at least one prescribed medication will have their registration fee of $125 waived.
Trinity Medical Associates is reigniting Liberty’s torch for all people to receive the highest quality medical care. Call today for an appointment and come be part of the new American healthcare dream.
This week my partner, Jackie Hone, was seeing a new patient who had driven an hour seeking her help in sorting out his health situation. She spent an hour seeking to undo the damage done by miscommunication from multiple encounters in varied medical settings. Her patient had been left confused, upset, and almost ready to give up. He was uninsured and prior to his current problem had been quite healthy and had no primary care physician. But following his recent shoulder surgery he experienced a concerning post-operative symptom, was sent to one ER, transferred to a second hospital, had his diagnosis changed several times, was admitted for a 4-day hospital stay, and was finally discharged still lacking a definite diagnosis, plan, or prognosis. Of course his medical bills are staggering from all of these encounters. He was left pondering, “If medical care costs so much, why is it so poorly delivered?”
Most of us somewhere along the way have had a frustrating medical experience: maybe we received only a fleeting explanation about a procedure, medication, or treatment being recommended. Or perhaps we received a surprisingly huge bill after the dust settled on our medical care. Or we had follow-up questions but couldn’t reach anyone to answer them. Maybe all of these. So, is that just the way it increasingly has to be, or is there a better way?
Having a relationship with a physician who knows us in times of health and sickness is valuable. Likewise having a doctor who can be reached in an emergency is huge. And having a physician’s office that can help us navigate complicated medical tests and specialists to anticipate and manage costs is something for which most can only wish. But maybe these things are not impossible to achieve.
My partner and I believe that a return to direct agreements between doctor and patient is the first step toward providing this experience as the new normal in primary care. I am referring to the medical care model known as Direct Primary Care (DPC). It is so named because patients deal directly with their doctor to form an agreement defining what services and care will be provided for a known and affordable monthly membership fee, rather than billing for services through the middle-man of insurance. One recent joiner to DPC had calculated that his medical cost for primary care would only be about 30% under DPC compared with what he had paid for primary care coverage by insurance the previous year.
Now that Dr. Hone has been practicing a DPC model for the past seven months, we can report that patients in this model are very satisfied with their care, are able to communicate efficiently with our office, and can be seen when needed. Their visits are not so rushed, their wait times have been reduced, and cost is highly affordable due to the reduced overhead from not having to jump through the countless hoops of insurance companies.
The basic fee, not much different than a cell phone contract, covers all basic primary care including normal labs, physicals, maintenance visits and sick visits. Any procedure or lab not included in the membership agreement is offered at a low cost compared to insurance rates, and is discussed in advance with the patient. The lower patient volume in DPC allows more “face time” with patients which translates to better communication all around, the chance to be heard by the doctor and ask questions, and the efficiency of handling more than one complaint at a visit. Because payment is based on a monthly fee, rather than an office visit, communication by phone and email is welcomed rather than discouraged (as it often is in an insurance-based model). Finding the right catastrophic coverage that provides for unforeseen emergencies, imaging, or specialists, is important to complete the picture.
Of course there are still a few folks who have great insurance and may not need Direct Primary Care to help healthcare be affordable and personal. But for many patients we have found that it works wonderfully, saves them time and money, and improves their overall healthcare.
In light of all this Dr. Hone and Trinity Medical are celebrating the Grand Opening of her new office next to Sonic at 1515 E Lamar Alexander Parkway on Thursday, August 11th from 11:00-1:00pm. If you have a few minutes, check it out and find out a bit more about how Direct Primary Care really can be a better way.
…in the waiting room because the doctor is running late (again)!
In the DPC model of care, I get to spend more time with each patient. I don’t have to try and polish my skills at polite interruption because I have other patients waiting. Instead, each visit is long enough to cover the majority of concerns a patient my have. If not, we can easily prioritize which concerns to cover and schedule a follow up visit (again, with no per visit fee) to address the rest. That means I can stay on time virtually all of the time. Many of my DPC patients don’t even have the chance to sit down in the waiting room before being shown to their room and I’m ready to walk in as soon as they are settled. I love this model of care and I think my patients do too. I do feel sad for all the leisure reading my patients will miss out on while waiting in my lobby.
If you’re interested in learning more about Trinity’s Direct Primary Care program, then send me an email at firstname.lastname@example.org or call my DPC coordinator, Mel Moss, at 244-1800. We’d love to talk to you more about the program and explain how it can benefit you and your family. When you’re ready to experience the Direct Primary Care program you can sign up at Trinity Direct Primary Care Sign Up.
The Knoxville News Sentinel published my opinion piece about the value and necessity of Direct Primary Care for Tennesseans in today’s edition. Thanks to the Beacon Center of Tennessee for helping to promote this piece as well as promoting good legislation that would allow DPC practices to thrive in our state. A good DPC practice provides individualized medical care to its patients at a dramatically lower cost and encourages other good physicians to move to our community while allowing a longer, more fruitful, career for those physicians considering early retirement as part of the epidemic of bureaucratic burnout.
Dr. Mark B. McColl: Direct primary care best medical model