Part of a series. Is concierge medicine for everyone or is it just for the rich, the 1%? Most people assume it is for the elite and cannot be afforded by the common man, the masses. That is unfortunate because in many cases it can be quite affordable. Here are three examples. AtlasMD in Kansas City and others like it think of themselves as “blue collar” concierge practices. According to ...

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One of the skilled nursing facilities I work with has a hospice unit.  We occasionally have patients on the hospice unit who might benefit from physical therapy.  The physical therapists that see patients in the skilled nursing facility say they will talk with the patient about their goals, and if their goals are to maintain their current level of functioning, they will work with the patient.  If the goals are ...

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The house was getting cold.  My wife and kids snuggled in their blankets as I crept out of bed and checked the thermostat.  The subzero winter air howled as a blustery morning took shape outside our windows.   I looked at the digital display with disbelief and manually tapped the screen with my finger, hoping that the jarring motion would loosen the exact faulty screw leading to our frigid state. ...

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Today, I celebrated mental health care.  And this was after a morning of battling with insurance companies, patching together community care plans, trying to create an inpatient bed for a suicidal patient where none exist, and arguing with agencies for better patient support. I work on a busy inpatient psychiatric unit that provides a daily reminder of the beauty, heartache, and pain that define living with mental illness.  The diverse stories of ...

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“Dr. Liu, I don’t think he has diverticulitis.” So said the second-year medical student. She had just completed her first year of anatomy, biochemistry, pathology, and introduction to doctoring at the local medical school. One of the sharpest medical students I’ve proctored. Like many summers, I’ve been fortunate to spend time with the next generation of doctors. These future doctors were brimmed with enthusiasm and energy.  Instead of taking time off to ...

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Doctors still work while on vacation Last week, I took a 6-day vacation.  Two days before and two days after, I put in a total of 32 unpaid hours of work which was cut short by a call from my daughter asking me why I am working during my time off.  While away with my family, I ran into people of different walks of life and noted ...

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Sandeep Jauhar has this wonderful sentence in his New York Times op-ed, "Busy Doctors, Wasteful Spending": "There is no more wasteful entity in medicine than a rushed doctor." And yet physicians are rushed. Dr. Jauhar writes about the payment system driving shorter visits. That problem represents an important component of undesirably short visits, but it is not the only problem. The electronic health record adds documentation time, as do the billing ...

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The secret lives of doctors Recently, when my parents came for a visit, our conversations led me to realize something important: I have been a doctor for more than 20 years, and yet my parents have no idea what my daily life is like. It then occurred to me that if they have no idea, then surely my patients have no idea either. So, if you're a ...

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Dear patient: Your 5 minute appointment is awaiting you. Dear patient: I am writing to inform you of some recent changes to my practice. These changes have been implemented to improve the quality of your care. I will no longer be able to see you for a 20-minute or 40-minute appointment. These will instead be shortened to a 10-minute or 20 minute-appointment based on your stated needs. For example, if you just ...

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A 32-year-old woman recently came to see me for an opinion on stomach pain.  Why would I refuse to see her again?  Abdominal pain is an everyday occurrence for a gastroenterologist.  She was accompanied by her mother.  I had never met this woman previously. She had suffered abdominal pains for as long as she could remember.  She recalled frequent visits with the school nurse when she was a young girl. She has abdominal distress ...

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