February 10th, 2010 by SteveSimmonsMD in Primary Care Wednesdays
Tags: DocTalker Family Medicine, Dr. Steve Simmons, Primary Care, Primary Care Wedesdays, Telemedicine
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I practice medicine in the suburbs west of Washington, DC, and everywhere I look I see 30 or more inches of snow. I keep reminding myself of where I am –not unlike a man pinching himself to ascertain wakefulness–because the view my window affords me is tailor made for the usual snow typical to Buffalo, NY. Two days after the snow stopped falling, schools are cancelled indefinitely, most side streets have yet to see a plow, and tens of thousands are without electricity including my partner’s family huddled together like in a dark basement enjoying the extra two or three degrees of warmth to be found there.
It is hard, but not impossible, to practice medicine when the pace of modern society grinds to a halt. Yet at least we, here, enjoy the benefits of living in a country with a well developed infrastructure prepared to rebound instead of recoiling from nature. To compare our “snowmageddon” (a term used on the news here) and the earthquake in Haiti would be both inappropriate and naïve; yet, our daily lives have distinctly altered and in that an understanding of the fragility of society and the responsibility of a physician is possible. Still, there are many differences. We ask when our power will be returned, not if; snow will melt, but buildings don’t un-crumble; and while my neighbors shiver together in their homes, many Haitians seek their loved ones with a shovel.
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February 3rd, 2010 by AlanDappenMD in Primary Care Wednesdays
Tags: DocTalker Family Medicine, Dr. Alan Dappen, Health Insurance, Primary Care
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Introduction: To those readers picking up this series for the first time, here’s a synopsis for you: Mrs. Doctor is a primary care physician who is in an unsavory marriage with Mr. Insurance. They care for their adult children (Patient 1, Patient 2, Patient 3…) with the following arrangement: Mr. Insurance will take care of all the financial requirements by paying Mrs. Doctor and to do all the caring and nurturing to keep the kids well.
Mrs. Doctor has come to realize that Mr. Insurance is a jerk and asks her to do more and more while giving less and less money for the care of the kids. Mr. Insurance refuses to see anything wrong with his relationship he has stonewalled all requests for marriage counseling. Mrs. Doctor began counseling on her own to ponder her dilemma through the impartial eyes and ears of a marriage and family therapist. Read more »
January 27th, 2010 by AlanDappenMD in Primary Care Wednesdays
Tags: DocTalker Family Medicine, Dr. Alan Dappen, Health & Wellness, Primary Care, Wellness
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Health and wellness go hand in hand; there is little question of this. I therefore ask why isn’t primary care at the heart of the health and wellness movement? This, I feel, would make outstanding economic sense for all involved.
In an effort to survive these sour economic times, more and more companies are trying to stave off the escalating cost of healthcare by pushing for wellness. There is good reason for this. According to Buck Consultant’s third annual global wellness survey which was cited on the Society of Human Resources Management web site those U.S. companies who measured financial outcomes of their wellness programs reported a 43% reduction in healthcare costs or about two to five percentage points per year. Read more »
January 20th, 2010 by AlanDappenMD in Primary Care Wednesdays
Tags: Concierge, DocTalker Family Medicine, Dr. Alan Dappen, Pay-As-You-Go, Primary Care, Shortage of Primary Care Pracitioners
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I bristle when my patient-driven, fee-for-service primary practice, DocTalker Family Medicine, gets lumped into the “concierge” movement, as it frequently does. First, veterinarians, accountants, mechanics lawyers and all other service providers in everyday life who work directly for their clients and not as “preferred providers” for the insurance companies are not labeled “concierge.” Secondly, the label “concierge” implies exclusivity, membership, high yearly retainers, and capped patient enrollment. Each of these labels we too reject.
A practice like ours out-competes the traditional model and the “concierge idea” in almost every measurable way: access, convenience, patient control, speed to treatment, quality and finally and maybe most importantly for the sake of the health care debate, price. Our boss is each patient one at a time, and our goal is to provide the most cost effective delivery model achievable. We strive for nothing less than making primary care immediate, high quality, patient controlled and affordable to every American. We deliver a concierge-level service at a price that is much less than even the price-fixing controlled by the insurance-driven model to date. Read more »
January 13th, 2010 by SteveSimmonsMD in Primary Care Wednesdays
Tags: DocTalker Family Medicine, Dr. Steve Simmons, Primary Care Wednesdays, Technology
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Some patients in the 21st century approach “modern” healthcare with the same expectations I bring into a deli for lunch: “I’d like the sinus infection with antibiotics and a note for work, please.” I confess, when seeing such a patient I have occasionally acted on the impulse to ask if they would like fries with their order. Yet, these patients do have something to teach us about how to be a 21st century physician.
Eighteen years ago while a fourth year medical student I registered for an elective class on the future of computer science in medicine. This was my first time to see the Internet and I was awed by the vision my instructors had for the future. They had no idea. Read more »
