The landscape of healthcare has dramatically changed over the last 30 years since I have been practicing medicine. Advancements in technology have improved outcomes and longevity for many but in other ways the quality of care has not kept pace with the times. Don’t get me wrong, this is not due to the physicians lack of concern or caring but is due to an ever tightening squeeze on physician time by an insurance paradigm that does not work. For patients with a chronic, debilitating illness it seems frustratingly broken and unrepairable. Healthcare reform has done nothing to advance the physician-patient relationship. In fact, it has eroded the level of trust and privacy that had always seemed sacrosanct inside of an exam room. Doctors are asked to jump over more hurdles, with less time and reduced reimbursement. They must do this in a way that still delivers quality healthcare to the patient.
Every day I hear and see the frustration of my chronically ill patients who have trouble getting medications and tests covered by their insurance. This often involves much office time to intervene and assist them in obtaining coverage. The complexities of the diagnosis, medication, test and insurance dynamic are immense. Patients are often disappointed in my inability to provide the time to fully address all of their complex medical issues in one visit. It’s a never ending loop of dissatisfaction that is disenchanting for all of us.
The current healthcare paradigm is also obviously not working from the physician’s perspective, as evidenced by the lack of physicians entering direct patient care. There is already a physician shortage and it is going to get worse. According to a report by the Association of American Medical Colleges in 2015, titled “The Complexities of Physician Supply and Demand: Projections from 2013 to 2025“, they state that by 2025 there will be a physician shortage from 46,000 to 90,000, with at least 12,000 to 31,000 of those from primary care. “The doctor shortage is real – it’s significant – and it’s particularly serious for the kind of medical care that our aging population is going to need,” said AAMC President and CEO Darrell G. Kirch, MD.”
Nothing is going to dramatically change in the insurance healthcare landscape any time soon. Patients are going to have to consider their priorities. How important is their health? What is required to obtain their goals? Are the tools and knowledge even available to obtain those goals? Where is all that available? Many of the new medical technologies are not covered by insurance creating a frustrating dynamic for all. Yet citizens of other countries that have no insurance coverage expectations leap into these new technologies resulting in an ever-widening chasm of quality of care. The United States has one of the poorest healthcare records among first and second world countries.
Privately funded extended care relationships with physicians are what has formed out of this need for more time and expertise for those that choose it. These extended care relationship plans allow for the doctor to spend more time with the patient. A more comprehensive approach to healthcare is now available. Time for patient evaluation and planning therapy options are now possible. Time to monitor the progress and adjust accordingly is now possible. Now and only now the treatments of these very complex modern medical illnesses is possible. The new era of regenerative and anti-aging medicine is now here and real. Healthcare outcomes previously dreamt of are now occurring for those who have chosen to pursue their goals and dreams in the New Paradigm.
The patients in these relationships gain increased access to their physicians ensuring piece of mind and a sense of security knowing that they have an expert in their corner.
The new future of health care will require patients to take a much more proactive and responsible role in their healthcare management. It will also require patients to prioritize their health in a way that they are not used to. For those that value their health, more of their budget will be spent on healthcare and it will be outside of the insurance system.
Towards the goal of improved medical care for my patients I will be focusing my time on those patients who have elected to make their healthcare a priority and have elected to join the Extended Care Program. This program will be limited to a select few. Contact the office to see if you qualify and reserve your spot in the program before it closes.
“If you risk nothing……you risk everything.” Geena Davis
References:
https://www.aamc.org/newsroom/newsreleases/426166/20150303.html
https://www.aamc.org/download/426242/data/ihsreportdownload.pdf
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