Progress Report

Today's post will not be my typical laser-focused gem of nuanced and knowledgeable insight. I am fighting off a cold and Mary Kaye is off to a scrapbooking convention, so today is a lazy day home with the kids. It is an opportunity to post on several topics I've touched on in the past, however.

Plans are apace for the Open House my office is having August 23. The Open House is being held to celebrate the completion of our first year of practice. We never held a Grand Opening because we were too busy from the start, but I wanted to celebrate what I believe is a successful start for our efforts at delivering primary health care in a different and better patient-centered model. We also wanted folks to see our expanded office space, which we just finished remodelling a couple of weeks ago. We have almost doubled our office's square footage, and have doubled the number of patient exam rooms. Another reason for the Open House is to introduce Tina McCall, our new nurse practitioner, to my patients. Tina's presence will help us tremendously as we strive to be conveniently available to patients, and we want to give folks a chance to meet her, as well as to publicize that work-in appointments, especially on Fridays, will be more available. Finally, we wanted to use the Open House in a low key manner to introduce the new Premier Wellness option that we are now offering. As I've noted before, Premier Wellness is an optional retainer-based program in which patients pay an annual or monthly fee in return for a wide-ranging annual Wellness Review, as well as guarantees of quicker work-ins and generally enhanced levels of office time spent discussing health issues.

I have developed the Premier Wellness program in an effort to insulate myself and my patients from what I fear are impending devastating public policies regarding reimbursement for health care services. My fear is that, as third party/government payors exert more and more influence on health care policy, the traditional and precious relationship between doctor and patient will be irreparably harmed. Only a socialist would argue that the individual's best interest is always concordant with society's, or the government's. Unless the patient is paying for the service, someone else is calling the tune. The practical result, I fear, is that without Premier Wellness or something similar, all primary care doctors will be forced into becoming "office visit mills" with limited time and little satisfaction for both patient and doctor. If I can develop a model in which patients feel valued and empowered and really "cared" for, a model in which the patients themselves decide the value of the services and whether to pay for them, then I will have protected some modicum of the traditional relationship between doctors and patients. I will have also salvaged that ideal which should motivate physicians--the concept of servanthood.

Too often, conservatives cede the moral high ground to liberals who preach generosity and unity, but the truth is that none of the ideals I've spoken of above can occur unless the staff is paid, the rent is paid, and the monthly bills are paid. I love the old joke about liberals, that they're so generous they'll give you the shirt off someone else's back. I'm here in the trenches, trying to care for folks, but I'm also saying that providing the care people want costs money, and that's a truth that needs to be faced. My Wellness option isn't for everyone, but neither is any other single option. The thrust of my position, however, is that patients need to control the system, and that will not happen unless they are also paying the bills.

With regard to Premier Wellness, I'm excited that the response to my initial offering has exceeded my expectations. I have already seen one patient this week as a Wellness patient, and I believe that this patient felt , dare I say it, pampered and well cared for. I was able to take the time to speak with a specialist about one of this patient's health problems, and arrangements were made for an expeditious office visit with the specialist. This was all able to be accomplished because I was able to allocate extra time with this patient. Time--that is the most important asset I have to offer patients, and the commodity that patients are being deprived of in today's system.

I am also trying to find other ways to add value to the product I offer Wellness patients. I have arranged a substantial discount for membership at a local water-based therapy center, and I hope to arrange access to an entity that offers gym and exercise equipment. I would also like to have my Wellness patients meet annually with a dietitian for nutritional counselling, and I'm going to try to add that benefit at no extra cost to the patient. Offering these and other benefits will help these patients achieve their goal of good health and access to personalized care that is convenient for them. I am proud to be part of the process.

I'll close with a word about Presidential politics. It goes without saying that all the Democratic proposals regarding health care are horrible. Among the Republicans, there is a glimmer of sense. Giuliani, whom I've slammed for his pro-abortion stance, has made headlines recently with an outline which seems to try to apply market principles to health care spending by making individual health care premiums tax deductible. This proposal is good in that it weakens the artificial and harmful linkage between employment and health insurance. Mike Huckabee, who I believe is the most engaging and credible conservative in the race, has a good strong tax policy proposal called the FAIR tax. I need to learn more about his health care spending proposals. Huckabee needs to do well in an upcoming Iowa straw poll next week. I hope he does.