The majority of people in this country think we have a reasonably good health care system, but also feel there is a lot that can be done to improve on it. The health care bill passed last year by Congress is a prime example of trying to enhance what is currently in existence. As a practicing primary care physician over the last 20+ years, I have heard four common complaints about our current health care model:
1)”I can’t get in to see my physician the day I need him/her.” This is an access issue which is generally caused by overbooking patients. Physicians overextend participation in different insurance plans and accept too many patients in order to make up for lower reimbursement rates. As a result, too many patients compete for limited appointment slots, delaying care.
2)”He/she didn’t spend enough time with me or was late.” This is largely due to what was described in #1; too many patients per provider. It is dangerous in many cases for the patient to only get the national average of 10 minutes with a physician. There is no way in this short amount of time for a competent physician to take a thoughtful history, adequately examine a patient with a complicated problem and then arrive at an accurate diagnosis in order to provide appropriate care.
3)”I couldn’t believe the charge.” Fees are usually calculated to be slightly more than what the best paying insurance company reimburses the provider. When a patient has no insurance or has to pay his deductible first, he feels the full brunt of the bill. Patients commonly think that they are charged by the time spent by the physician. This is not true. Insurance contracts require a complex coding system that base fees on complexity, competing diagnoses and risk of injury or death if the wrong diagnosis is made. It is also true that uninsured and underinsured patients essentially subsidize insured patient visits, largely because insurers usually discount payment (often dramatically) to the physician.
4)”We usually talk only about what is wrong and how to fix it.” This is known as the sickness model and is what the majority of the curriculum in Western medical education is geared towards. This approach is also prevalent because it takes less time with the patient and reimburses better. Until quite recently, insurance plans did not typically cover preventative visits such as those devoted to weight loss, smoking cessation and exercise. Wellness medicine has been shown to save health care dollars, because people get sick less often and, as a result, go to a physician or hospital less. Adequate preventative care also takes more physician time, which is especially hard when there are too many booked patients.
Our practice was founded largely to address these four complaints and to offer a better, more patient-friendly health care model. Same day appointments are almost always available, and our average wait time as well as time spent with the physician is far better than the national average. Our average patient charge is only about $10 more than the local government-subsidized health care clinic, and we place a priority on preventative medicine. Although we do not believe that we have all the answers to our current health care debate or are the right practice model for every patient, we feel we are headed in the right direction. Check us out…RRS