Doctors should ask the people what they want for health care

Americans typically rely on elected officials to uphold the will of the people. Now physicians—traditionally confined to exam rooms—are taking direct action to fulfill community needs.

In 2004 I decided to meet face to face with citizens in my hometown. I thought, “Why wait for legislation? I’m a board-certified physician. What’s stopping me from serving the public?”

So I led town hall meetings and invited ordinary citizens to create the clinic of their dreams.

From living rooms and Main Street cafes to neighborhood centers and yoga studios, I met directly with people and listened to their wisdom. Bus drivers and businessmen, housewives and healthcare workers, teachers, college students and folks of all ages gathered to design a new model, a template for the nation.

I asked each participant to imagine walking into an ideal clinic in an optimal healthcare system. Community members shared their visions; most submitted written testimony. My job was to implement their ideas where feasible.

From nine town hall meetings over six weeks, I collected one hundred pages of written testimony, adopted 90% of feedback, and opened our clinic one month later. For the first time my job description was written by my patients, not administrators.

What do people really want? Surprisingly, it’s nothing too extravagant. Here are their top ten recommendations, many in their own words:

1. Real relationships. Be fully present and willing to touch patients emotionally, spiritually, and physically. One woman’s simple request: “Hug me!”
2. Physician role models. Happy, healthy doctors inspire patients to live happy, healthy lives.
3. Integrative healing. All healing arts professionals should work together. Add on-site complementary therapies such as massage, yoga, and acupuncture.
4. Sacred space. An ideal clinic is “a sanctuary, a safe place, a place of wisdom . . . a place where we rediscover our priorities.”
5. Easy access. Same day appointments offered and everyone receives care when they need it.
6. Relaxed appointments. Visits are, at minimum, thirty minutes. Patients want to speak uninterrupted and “feel heard, understood, and cared for.”
7. Patient-centered care. One citizen’s advice: “Abolish cookie cutter medicine—everybody does not need the same thing.”
8. Community orientation. A doctor is part of the community and “knows everyone by their first name . . . knows patients in a social context.”
9. Creative financing. Offer patients an array of payment options: Consider monthly stipends and sliding-scale discounts. Accept donations, bartering, and insurance when possible.
10. Heath education. Transition from an acute care delivery system based on intervention to wellness-oriented healthcare system.

Doctors don’t usually ask for help, but sensible solutions are literally right next-door.
 I invite you to talk with your neighbors, to engage with your community, and most importantly, to act on what they tell you.

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care.


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