Category: Integrative Medicine

The "Reinvention" of Primary Care Delivery

5/25/2018

Happy almost summer! Being a sun worshipper, I am always energized by the longer days and sunnier weather, although in Seattle we are definitely not done with rain just yet.

This month I wanted to share some thoughts I had after reading an excellent article in the New York Times Magazine about the “reinvention” of primary care delivery. It features the work of Dr. David Meltzer from the University of Chicago, who was a speaker at one of the national conferences of the National Association of Healthcare Advocacy Consultants (NAHAC), my professional organization as an advocate.

His research looked at the doctor-patient relationship, and whether longer appointments with a person’s primary care doctor (yes, all of them with the same doctor!) were economically sustainable.

Trying to Put a Value on the Doctor-Patient Relationship
by Kim Tingley

From the article :

“Meltzer insists that doctors spending more time with their patients actually saves money. After a year in his clinic, for instance, patients have 20 percent fewer hospitalizations than their control-group counterparts. Because hospitalizations make up the greatest portion of these patients’ annual cost to Medicare, which averages $50,000 to $75,000 each, that reduction is worth several thousand dollars per person in the first year, or a combined several million dollars; by comparison, the doctors’ annual salaries add up to less than $1 million.”

Dr. Meltzer’s clinics run “leaner”—fewer people in the mix, and:

“To accomplish this feat, he employs the oldest, slowest, least-innovative health care delivery model imaginable: general practitioners who oversee almost all aspects of their patients’ care and, in doing so, come to know them personally.”

What I love about this article (besides the fact that it validates what I have been saying for years) is that it shows that this essential factor in healthcare actually makes a difference, and not just emotionally, which I think most of us believe. It makes a difference economically also, and it made a difference in the health of the patients.

It’s a win-win-win. Yes, I believe technology can help with communication and efficiency, and definitely with access to knowledge. And yes, the huge amount of medical knowledge requires subspecialization since no one can master all the information available in a single specialty. But there needs to be a quarterback that knows the patient and sees them as a whole. This is what I do as an advocate, but I believe that ideally the primary care doctor would fulfill that role and I would no longer be needed!

Now, how do we get the medical industrial complex to listen?

Tom Brokaw, Humphrey, and a Road Map for Integrative Care

9/25/2015

Most people, I have found, don’t know that they can access someone to help them through the complex and convoluted medical system, and even more concerning, don’t realize how much they need someone to do just that.
I want to share with you two articles that really spoke to me about the necessity of having an advocate when going through a difficult medical problem. This first one mentions someone who we all recognize, Tom Brokaw, and what he felt he needed when he was treated for multiple myeloma.
A CANCER PATIENT LEARNS THE BENEFIT -- AND NECESSITY -- OF HAVING A PATIENT ADVOCATE
Not only is Tom Brokaw’s daughter an emergency medicine physician, she has worked as a healthcare advocate as well. And with all that he is able to access, he still felt uncomfortable with the “lack of shared dialogue” in his treatment—what I would call lack of coordination of care or project management. This truly does give me pause. If he found this difficult, it is abundantly clear that we would certainly find it so.
The second article is about the ideal coordination of care—sort of a best-case scenario for how to navigate through a health crisis.
WHEN CONCIERGE CARE IS RESERVED FOR PETS
The journey of the author of this article and her cat, Humphrey, through the veterinary healthcare system made me envious of this marvelously integrated care. And it also provides a road map for what we could have if we had the will to make it happen.
I would love to hear back from all of you with your thoughts and questions about these articles, or topics you would like to hear about.

The "Reinvention" of Primary Care Delivery

Trying to Put a Value on the Doctor-Patient Relationship
by Kim Tingley

Tom Brokaw, Humphrey, and a Road Map for Integrative Care

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The "Reinvention" of Primary Care Delivery

Trying to Put a Value on the Doctor-Patient Relationshipby Kim Tingley

Tom Brokaw, Humphrey, and a Road Map for Integrative Care

Author

Archives

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Trying to Put a Value on the Doctor-Patient Relationship
by Kim Tingley