When I think of the plight of primary care practitioners, particularly in the light of today’s discussion of healthcare reform, I often think of a Dr. Seuss book. My mother read it to me as a child recovering from the chicken pox. I read it to my two sons when they were young. And I encourage you to read it too, even if you’re an adult. The book is entitled Thidwick The Big-Hearted Moose. To me, this 1948 story almost perfectly mimics the overburdened lives of primary care physicians and the innumerable squabblers who’ve come along for the ride in the misguided world of healthcare.
For those who haven’t read Thidwick, here’s a recap of the story: Thidwick is a kind “big hearted” moose blissfully grazing with the rest of his herd on Lake Winna-Bango, minding his on business. One day a Bingle Bug asks if he can ride upon Thidwick’s enormous antler rack for free. Read more »
During the past several weeks, I have diagnosed several patients with novel H1N1 influenza infection with my diagnostic opinion occasionally backed by a positive flu swab. When my wife, an ER doctor, fell ill I suggested she had novel H1N1 infection and went on to advise some of my family, friends, and neighbors of the likelihood that they too had H1N1. Yet when it was my turn to suffer with fever, body aches, headache, sore throat, and malaise one word seemed best able to convey how I really felt: swine.
My symptoms began four days after having the H1N1 shot and almost immediately after putting my children to bed following a fun but rainy Halloween night. It would have been nice to blame the rain or the flu shot for my suffering but I knew better. Unable to sleep I found myself ruminating over an aphorism I first heard as a third year medical student, spoken by a man who lives in my heart as my mentor. Read more »
I am approaching an important anniversary of my heart attack. Until then, I had missed but a single day of work due to illness since starting medical school in 1975. Even in the middle of the heart attack, I played an entire ice hockey game, slept a few hours, had a business meeting with a fellow doctor at Starbucks, and went back to the office to see patients. In retrospect, my actions could be labeled as folly, bravado, machismo, denial, and lucky. I accept all labels as true. Without a trace of shame I have shared this archetypal story with friends, and patients hoping that by laughing hard enough at me, I might prevent at least one person from dropping dead from stupidity. Read more »
I was interviewed about my participation in DocTalker Family Medicine, a new type of medical practice that dramatically reduces the administrative burden of healthcare. The solution is easy: transparent fees, low overhead, reliance on technology, and no insurance paperwork. Patients who are tired of waiting to see a doctor, or filling out insurance forms, can get immediate care, generally for under $50. The average patient in our practice spends under $300/year on their primary care – and carries insurance for catastropic events.
As a primary care practitioner, I often am baffled by why Americans need insurance for primary, or day-to-day, care issues. When I’m talking about primary care, I mean those health problems that are considered routine, or day-to-day, problems including ear infections to poison ivy as well as many urgent care issues like sutures and draining infections. These account for a large portion of all health problems that occur in the U.S – and 80% of the things that typically up in the ER or urgent care.
My understanding is that the purpose of insurance is to protect our financial well-being and thus our financial nest egg. Investorpedia, which is part of Forbes Digital Media, offers the following definition: “Insurance allows individuals, businesses and other entities to protect themselves against significant potential losses and financial hardship at a reasonably affordable rate.”
This definition explains why we invest in insurance of all types: car insurance, home insurance and health insurance.
Then I wonder why our expectations and utilization of health insurance differs so significantly from home or car insurance. I pay a monthly premium for my car insurance, and it protects me against having to pay out large sums of money if I would be in a bad car accident. I don’t expect, however, my car insurance provider to pay for an oil change or new battery. Likewise, I pay a yearly premium for my home owner’s insurance, yet I do not expect the insurance company to foot the bill if I need a new screen door – but I certainly will turn to them if a tree crashes through my garage during a bad storm.
Then why should I expect my health insurance to pick up every small, day-to-day health issue that I have, particularly those that can cost less then $150, like a well-woman physical, help with pink eye, a tick bite or extricating a fish hook?
Don’t get me wrong; I feel that health insurance is a must to protecting anyone’s financial assets against a potentially catastrophic health event, like a tragic accident or illness. We all need to be ensured that we will not go broke if we are faced with such health issues.
I currently work for a primary care practice, DocTalker, is built to deliver affordable access to our medical team, round the clock, to ensure that our patients save cost and time. Our patients pay for a doctor’s fees when service is rendered. We base the fee structure on time and materials; our patients pay us for the amount of time they spend with the medical team. An office visit typically lasts for 15 minutes and costs $75. Believe it or not, roughly 75% of our patients pay less than $300 per year for their primary and urgent care health issues. I know of a lot of people who pay that in one office visit to the vet!
Our philosophy is that the faster we can talk to and treat our patients, the faster they will get better, thus saving them time and money from lost work, not to mention saving them in expenses from waiting to treat a condition that can worsen with time (like bronchitis). Once we’ve met with a patient face-to-face, we offer phone and email consultations, which typically cost $50.
The other thought is that if people pay, out-of-pocket, for their day-to-day care problems, then they will be more like to be aware of the cost and quality of the care they receive – much like they are with that vast majority of other purchases that they make, from a car to cell phone service to food. This will cause the consumer to demand a higher quality of care for a better price, and will lead to consumer choice and thus to consumer’s driving the market.
I don’t think that a price tag of $300 for the care of majority of primary and urgent care problems is really that much to ask; after all, many of us pay this much when we have a plumber come to the house to unplug a sink.
I think that my health is worth as much as an unplugged sink. I believe we do can it at a less expensive price. Don’t you?
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When I think of the plight of primary care practitioners, particularly in the light of today’s discussion of healthcare reform, I often think of a Dr. Seuss book. My mother read it to me as a child recovering from the chicken pox. I read it to my two sons when they were young. And I encourage you to read it too, even if you’re an adult. The book is entitled Thidwick The Big-Hearted Moose. To me, this 1948 story almost perfectly mimics the overburdened lives of primary care physicians and the innumerable squabblers who’ve come along for the ride in the misguided world of healthcare.
