Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Putting patients first by letting patients go

Cynthia Williams, MD
Physician
June 9, 2019
125 Shares
Share
Tweet
Share

Like many primary care physicians in this health care marketplace, I found myself operating on a hamster wheel of volume care, seeing more and more patients and spending less and less time with them.  The pressure on my practice, my patients and my staff was unsustainable.  With new regulations and declining reimbursements, there was no way to provide the levels of support and service that are so important, especially to older patients or my more vulnerable patients who juggle complex situations.

My patients wanted more from my staff and me, and as their physician, I wanted to ensure their needs were met. That’s why five years ago, I started my hybrid concierge program.  A hybrid concierge program is different than more commonly known concierge programs in that it allowed me to offer concierge service to those patients who join, while continuing to care for my traditional patients.  It gave me breathing room in my schedule. For at least part of my day, I could take a step back and practice at a slower pace, to provide the counsel and care coordination that, in traditional practices, there just isn’t time for anymore.

I didn’t know what to expect.  I was devoted to my patients, and I didn’t want them to feel pressured to join my concierge program, but I did want them to know that more time with me was possible, if they felt they needed it.  The results were overwhelming.  My hybrid program was filled immediately and remained full, with a waiting list.

It became clear to me that as much as primary care physicians like me were struggling under the immense pressure put on the health system, patients were struggling too. The population is getting older.  Baby boomers are entering retirement.  Adult children are moving away from home leaving aging parents to navigate a complex, often digital, health system entirely on their own.  This hasn’t been easy for anyone.  It hasn’t been easy for me to provide a senior with a list of referrals to a specialist and not help them secure that appointment. It isn’t easy for an elderly patient to sort through a complicated phone bank and then wait on hold just to make an appointment.  It hasn’t been easy for me as I worry about whether that patient is scheduling the follow-up appointment I insisted upon. And I know it isn’t easy for my busy patients to take off work and spend extended time waiting for their appointment to start.

During concierge hours, I didn’t have to worry as much, and neither did my patients.  Because of the limited nature of the program, I had the time to personally follow up with patients, to make sure my staff helped them schedule appointments with specialists. I was able to have telephone consultations with out-of-state family members who manage the care of their parents. Patients with medical concerns were able to reach me directly, even after hours. They knew that when they came in for their appointments, they would always see me—not another provider in my group. Caring for patients in this manner was the way I dreamed of practicing when I was a student. I wanted to be the community doctor that helped not just with prescriptions, but with prevention. I wanted to be there for my patients when they needed me most.

As the months turned into years, demand for my concierge services increased.  I let my hybrid program grow a bit.  Then a bit more.  I had to stop accepting new patients—there was no choice.  And then I finally had to make the hard decision to end my traditional practice altogether.  This was a tough decision to make, but turning away patients who needed the extra services my concierge program offered was also difficult.  I couldn’t juggle it all and be the doctor I wanted to be.

The real story here is not me. It’s the patients.  Why would so many patients be willing to pay an annual membership fee to be seen by a primary care doctor, in an era where urgent care clinics and minute clinics abound?

It’s because good health is personal, and there aren’t enough doctors in my area to care for each patient with the attention and support they deserve.  It’s because people are aging, and it’s important for doctors to be able to see the nuance in their patients — not just in their blood pressure, but in their attitude.  How could a doctor who doesn’t know a patient tell if the patient looks worn out?  Pale?  Depressed?  There is no substitute for a doctor who knows you.  There is no substitute for a doctor who has time to encourage you and motivate you to stick with a medication or treatment plan, a weight loss program, to nurse you through a challenging break up, the death of a loved one.  For adult children with full-time jobs and families of their own, there is no substitute for the ability to send a quick email to mom’s doctor asking if sore muscles is a side effect of the new medication, or to let the doctor know she’s feeling better and her appetite is back.

The health care marketplace is trying to make quality health care accessible to patients by adding providers at a multitude of levels and locations.  There are minute-clinics at drug stores, urgent care clinics for everything from pediatrics to orthopedics. But to merely have access to medical care isn’t the only thing that’s important to good health.  Patients need peace of mind, compassion, care coordination, and coaching.  They need to know they are getting advice from a person they trust.  And that’s why my practice was able to successfully introduce a hybrid concierge program and why we made the transition to full concierge.  These choices aren’t easy for patients to make, but concierge medicine isn’t a luxury anymore.  And practicing medicine in this volume care climate isn’t easy for physicians either.

Cynthia Williams is an internal medicine physician.

Image credit: Shutterstock.com

Prev

9 things I learned when purchasing disability insurance

June 9, 2019 Kevin 3
…
Next

How acknowledging others can keep us from burning out

June 9, 2019 Kevin 0
…

Tagged as: Primary Care, Public Health & Policy

Post navigation

< Previous Post
9 things I learned when purchasing disability insurance
Next Post >
How acknowledging others can keep us from burning out

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • Fixing health care requires putting patients and their health teams on top

    Matthew Hahn, MD
  • Physician Suicide Awareness Day: Where are the patients? 

    Jennifer M. Sweeney
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • Primary care makes a difference for patients and the nation

    Glen R. Stream, MD
  • Lawmakers don’t care for our patients. Doctors do.

    Joanna Bisgrove, MD

More in Physician

  • Discover your true north: Navigating life’s confusions and embracing your path to success

    Tyler Jorgensen, MD
  • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

    Anonymous
  • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

    Veronica Bonales, MD
  • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

    Arthur Lazarus, MD, MBA
  • Breaking free from restrictive covenants to combat burnout

    Raya E. Kheirbek, MD
  • From medical student to intern: Discovering a deeper connection with patients

    Johnathan Yao, MD, MPH
  • Most Popular

  • Past Week

    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • Discover your true north: Navigating life’s confusions and embracing your path to success

      Tyler Jorgensen, MD | Physician
    • A revolution in patient empowerment: Working together to save our medical system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • Unlock financial freedom: The physician’s guide to lucrative multifamily syndications and wealth accumulation

      Pranay Parikh, MD | Finance
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

      Veronica Bonales, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • New Antiviral Option for CMV Prophylaxis After Kidney Transplant
  • Infant RSV Vax Heads to FDA for Review
  • Is Getting Test Results Online Right Away a Good Idea? Yes, Patients Say
  • Residency Application System Cuts Section on Hobbies and Interests
  • Workplace Harassment, Cyber Incivility High for Minority Groups in Academic Medicine

Meeting Coverage

  • Phase II Study: Bispecific Oral Drug Tops Leading JAK Inhibitor for RA
  • Closing the Diversity Gaps in Urologic Oncology Leadership
  • Certain NSCLC Patients May Be Able to Stop Immunotherapy at 2 Years
  • No Survival Benefit With Immune Checkpoint Inhibitor Rechallenge in Metastatic RCC
  • Happy Sleep, Happy Couple?
  • Most Popular

  • Past Week

    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • Discover your true north: Navigating life’s confusions and embracing your path to success

      Tyler Jorgensen, MD | Physician
    • A revolution in patient empowerment: Working together to save our medical system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • Unlock financial freedom: The physician’s guide to lucrative multifamily syndications and wealth accumulation

      Pranay Parikh, MD | Finance
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

      Veronica Bonales, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Putting patients first by letting patients go
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...