Part of a series. Patients need doctors that take time to listen which means a limited number of patients under care. Employers need programs that reduce costs and ideally improve the health of their staff. These apparently disparate needs can come together in a new model for effective company-sponsored primary care programs. Those of you who have followed this series know that I am an advocate for PCPs finding ways to ...

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Part of a series. Employers have seen their health care costs rise dramatically over the years. To compensate, they have expected employees to pay an increasing portion of the health care insurance premium, expected employees to pay significant co-pays with each physician visit and have purchased policies that restrict individuals to a narrow network of doctors and hospitals. Largely these have not worked. They have offset some of the expenditures but ...

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Part of a series. Helping employees improve their health is right for the company’s bottom line and is doing right by our employees.  Healthier employees are happier, demonstrate less absenteeism and presenteesism, and are more productive.  This is a win for everyone involved.   - John Torinus, Jr., a retired CEO and current board chair of Serigraph, Inc., a mid-sized Wisconsin company with about 500 employees In my earlier posts in this series ...

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Part of a series. Over the past few months KevinMD.com has posted a series of articles by me on what I call the “crisis in primary care.”  Most recently have been a few posts related to direct primary care. They have generated many comments: some pro and some con. I have greatly appreciated everyone’s interest; it makes it worth the time to write. I am also working on a book on ...

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Part of a series. A common criticism of direct primary care (DPC, membership/retainer/concierge practices) is the added expense: “Isn’t it too expensive?” Ways to think about the cost are to prioritize expenditures and to consider potential savings that make it cost effective. I gave examples of three direct primary care practices in an earlier post. Here is a recap of costs. AtlasMD’s annual fee is $600 for a young adult and ...

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Part of a series. In earlier posts, I have described direct primary care (DPC) in its various forms called membership, retainer and concierge. There are some concerns with DPC. Does more doctor-patient time really mean better quality care? Does it really mean lower total costs? It seems logical that closer care means better care, fewer referrals to specialists and fewer hospitalizations. Most DPC physicians will tell you this is the case ...

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Part of a series. Primary care need not be expensive and until the past few decades it was paid for out of pocket. Heretical perhaps, but it would be very useful to go back again to paying the PCP out of pocket directly by the patient, preferably with a tax-advantaged health savings account (HSA). A County Doctor wrote on his blog:

I can freeze a couple of warts in less than a ...

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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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Next in a series. The fundamental problem in health care delivery today is a highly dysfunctional payment system that leads to higher costs, lesser quality and reduced satisfaction. It also means less time between doctor and patient with the loss of “relationship medicine.” The core problem? Price controls and regulations that reduce the trust and core interactions between doctor and patient. The patient is no one’s customer and visit times ...

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Next in a series. What are some of the characteristics of healers? They listen and do so nonjudgmentally. They respond on the patient’s terms. They are humble. They are truthful. The healer communicates on the patient’s (and family’s) own terms. The healer always explains his or her reasoning. The healer tries to diminish the information gap. Despite all of medicine’s sophisticated technology and providers’ skills, the patient still needs the doctor ...

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