Want the Clinic of Your Dreams? Ask Your Community →

Tired of assembly-line medicine? Don’t wait for politician-saviors. Convene with your neighbors.

Americans typically rely on elected officials to uphold the will of the people, but decades of partisan struggle have stalled meaningful health-care reform. Now physicians are leaving exam rooms to take direct action.

In 2004 I had my epiphany: “Why wait for legislation? I’m a board-certified physician. What’s stopping me from serving the public?”

From living rooms to Main Street cafes, I held town hall meetings where I invited citizens to design their ideal clinic. Bus drivers and businessmen, housewives and hippies, teachers, and kids of all ages joined together to design a new model, a template for the nation.

So What’s an Ideal Clinic?

Mimi, a mother of two, shared: “An ideal clinic is a sanctuary, a safe place, a place of wisdom where we learn to live harmlessly, listen with empathy, observe without judgement. It’s a place where a revolution starts, where we rediscover our priorities.”

Lynette, a Chinese woman, added, “No front counters separating people from people, complimentary massage while waiting, fun surgical gowns!”

Jacob, a soft-spoken young man with dreadlocks, imagined “intriguing magazines” and a “pet cat that greets people at the door.”

A shy East-Indian student, Anjali, summarized, “Most importantly, the doctor would be someone with a big heart and a great love for people and service, someone whose presence itself is enough to cheer a patient. . .”

From nine town hall meetings over six weeks, I collected one hundred pages of written testimony, adopted 90% of feedback, and opened the community clinic one month later. For the first time my job description was written by my patients, not administrators.

The Patient’s Prescription

What do Americans really want in an ideal health-care system?

1. Authentic relationships: People prefer doctors who are fully present–emotionally, spiritually, and physically.

2. Integrative healing: All medical professionals work in concert. On-site complementary therapies such as massage, yoga, and acupuncture are accessible.

3. Physician role models: Happy, healthy doctors inspire patients to live happy, healthy lives.

4. Patient-centered care: One citizen’s advice: “Abolish cookie cutter medicine—everybody does not need the same thing.”

5. Flexible financing: Offer payment options: Monthly stipends, sliding scale discounts, bartering, and accept insurance when possible.

Health Care of, by, and for the People

Tucked in a wooded residential area a few miles from my home, is a sanctuary with yoga, massage, acupuncture, and a solar-heated, wheelchair-accessible indoor pool and hot tub. Follow a covered walkway to a clinic with overstuffed chairs and fun flannel gowns where patients enjoy thirty to sixty minute appointments; those who walk or bicycle to the office are rewarded with a selection of local handmade soaps and lotions.

The community clinic operates with no grants or outside funding. Malpractice premiums are discounted 50% as I work part time. Low overhead allows this one-physician, no-staff model to pass savings onto patients. Most insurance is accepted; uninsured receive 30% off with barter options available. Claims are processed through a free online clearinghouse. Administrative tasks and non-urgent calls are handled in my home business office at my leisure.

Is this a spa specializing in the worried well? Quite the contrary. Founding this community clinic has been the most personally and academically-fulfilling adventure of my career.

Case in point: Jacob–a thin, uninsured 25 year-old male whom I met at a town hall meeting–presented for a check up on opening day with a blood pressure of 220/120. My first diagnosis of renal artery stenosis. I accompanied him to angioplasty and that evening celebrated his new blood pressure–118/80–by sneaking Jacob and his family into the radiology suite to demonstrate his life-saving procedure with his very own catheters, wires and film images which I provided as souvenirs.

Physician, Heal Thy Profession

The care Americans want and deserve can’t be legislated by bureacrats. The time is now for physicians to bypass partisan discord and enact real change. Need help? Contact me at IdealMedicalCare.org

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Should Physicians Pay Patients for Waiting? →

Meet Elaine.

 

We lost touch for a while, but caught up with each other recently.

 

Like most girlfriends, we shared adventures of love, travel, and work. I told Elaine that I left assembly-line medicine. Now I  host town hall meetings–inspiring citizens nationwide to design ideal clinics and hospitals.

 

Elaine shared: “If I’m kept waiting, I bill the doctor. At the twenty minute mark, I politely tell the receptionist that the doctor has missed my appointment and, at the thirty minute mark, I will start billing at $47/hour.”

 

Wow! I had to hear more.


Elaine scheduled her physical as the first appointment slot of the day.  She waited thirty-five minutes in a paper gown before getting dressed, retrieving her copay, and informing the receptionist to expect a bill. The doctor pulled up just as Elaine was leaving.

 

Prior to her initial visit, Elaine signed the standard agreement outlining no-show and late fees. On follow up, Elaine knocked on the door and discovered her therapist with another client. He apologized for his scheduling error. Elaine sent a bill; check arrived the following week.

 

Elaine values herself and her time.

 

When the Comcast guy told her to wait at home between 3:00-6:00 pm, she said, “Expect a $141.00 bill. Is that okay with your boss?” A compromise: The driver agreed to call fifteen minutes ahead of arrival.

 

I was intrigued. Who pays for waiting?

 

Cab drivers charge hourly for waiting.  Restaurants may provide a discounted meal for the inconvenience.  Airlines cover hotel rooms for undue delays. Some physicians apologize. I offer a gift.

 

Central to medicine is a sacred covenant built on mutual trust, respect, and integrity. What happens when physicians fall into self-interest or self-pity?  Or when physicians are so emotionally, physically or financially distraught by their profession?

 

Patients suffer. And their wait times increase.

 

So what’s a doc to do?

 

1)  Remember: Respect is reciprocal. If physicians are on time, patients will be on time. If physicians don’t cancel appointments with little notice, patients won’t either. Doctors should stop charging fees they are unwilling to pay themselves.

 

2) Functional clinics attract functional patients. Patients fall to the level of dysfuntion within a clinic. A chaotic, disorganized clinic attracts chaotic, disorganized patients. Take care of yourself; uphold high standards and healthy boundaries.


3) Don’t wait. Doctors should apologize for delays. And if presented with an invoice for excessive waiting, doctors should gladly pay the fee. Fortunately, most patients don’t bill at the doctor’s hourly rate.

 

My opinion. Share yours:

 

 


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Take a Pinch of Optimism and Call Me in the Morning →

When’s the last time you felt euphorically hopeful?

 

When I inspire citizens to design ideal clinics and hospitals I feel exhilarated and, honestly, a bit manic. There’s something extremely energizing about helping people live their dreams. And the excitement is contagious.

 

Last weekend NPR aired my segment on creating dream hospitals. Before the interview was over I began receiving e-mails from listeners in Wisconsin and West Virginia.

 

Then Dave from North Carolina offered me a recommendation: Take a few pinches of whatever “IT” is that you have, put it in a an empty jar, stick on a simple label, and repeat a thousand times. Then carry the whole lot to flea markets across the country and sell each jar for a fair price. You will make a fortune AND you will leave a trail of happy, healthy, and energized ‘patients.’

 

Samuel Coleridge, an English poet and philosopher, once said, “He is the best physician who is the most ingenious inspirer of hope.”

 

Amid recession, depression and unemployment, patients seek more than another bottle of pills. They want a jar of hope.

 

Here’s my prescription:

 

1) Remember your dreams, your passion, your reason for being.

2) Every day inspire as many people as possible with your dream.

3) List everything that brings you joy. Do more of that stuff every day.

4) And don’t forget to smile!

 

 


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Advice for a Frustrated Gastroenterologist →

“I’m a gastroenterologist in practice for four years and frustrated, hopelessly unfulfilled with modern health care. I’ve even contemplated leaving practice. I love medicine and treating patients but I’m sick of the headaches of running a business and worrying about what insurance, if any, people may have. Thanks for your advice.”

Another day. Another urgent plea from a doctor.

I was once a discouraged doctor. I dreamed of returning to my college waitressing job just so I could be nice to people again. It is the patient relationship that is the greatest source of professional satisfaction for most physicians. So it is no surprise that assembly-line medicine fails us. Production-driven health care is an oxymoron.

The good news for my frustrated colleague is that we live in an era of transparency. Disintermediation or “cutting out the middleman” allows modern businesses such as eBay and Amazon to build direct relationships with clients. Even in medicine removing intermediaries saves money and renews patient-physician relationships.

Gandhi advises: “You must be the change you wish to see in the world.” Now is the time for innovation.

If you are sick of the headaches of running a business, remember medicine is a calling. Revision your practice. Align with your values. Simplify and find meaning.

Here’s my advice for the top five physician morale-busters:

1) Low reimbursement? Drop bad payors and provide cash discounts. Lower overhead; you’ll need less revenue: Expensive building? Downsize. High staff-physician ratio? Consider part-time employees; streamline tasks with technology.

2) Loss of autonomy? Limit bureaucracy. Scrutinize third party contracts and terminate burdensome relationships. Say goodbye to middlemen who undermine your ability to care for patients. It may be difficult–like leaving an abusive marriage–but I promise you’ll never look back.

3) Patient overload? Take care of yourself. Every stewardess warns: Put your oxygen mask on first then help your child. Empathy burnout and physician fatigue have real consequences. I recently read 20% more polyps are identified on colonoscopies performed before eleven in the morning.

4) Loss of respect? Safeguard patient relationships and enjoy renewed respect and appreciation.

5) Malpractice worries? The sacred patient-physician covenant is your best protection. Patients don’t sue doctors they like.


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America’s Healthcare Heroes →

Some heroes are not invited to the White House. Their opinions are not sought by Washington think tanks. There is no national holiday to recognize their contributions.

Welcome to IMCHeadline News! Here we celebrate the people who are living the dream and leading the way to ideal medical care for all.

Nominate your healthcare hero today!


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