Friday, October 29, 2010

1-900 Healthcare

I decided earlier in the week to see how much of my clinic I could accomplish over the phone if I had too. It was astounding. I figured out that at least 45% of the patients that I saw in the office could have been diagnosed and managed with a brief phone call. Many of the pateints were consultations from other doctors who just wanted a specialists opinion, others were just follow up.

I then started to wonder. We see the pateints in the office because that is how we get paid. What if we got paid for the phone calls? What if the standart of care included telephone consultations? I could see a lot more patients so the shortage of specialists in rural areas might be decreased. The cost of these consultations would be cheaper.

Oh, wait a minute. The last thing Medicare would ever do is something that would allow more patients to be cared for in a cheaper way. Afterall, they set what is and what is not paid for.


SeaSpray said...

Hi Throckmorton - interesting.

I would think you as a physician would gain with face to face because appearance, inflections in voice, etc also gives you info and ability to know a patient and same for patient to doctor. Also ..if you want repeat business ..meeting those consults, further cements you in their mind for future follow-ups because they connected with you ..handshake, visual, etc.

That being said ...I can see where once the pt-dr relationship is established phone consults, depending on circumstances would be easier for both Dr and Patient... and certainly saving money would be great, yet the doc could make more buy having time for more.

SeaSpray said...

Maybe you already know about this?

One of my docs joined this.

150.00 a month year round and his patients can join his concierge practice. But he will still see regular patients too although not accepting new ones. You get a cell phone number for 24hr access to him,instant appointments and I forget what else. So, I guess they pay this fee plus insurance is used.

Thought you might find this interesting.

I don't understand it though because isn't all the things healsa offers what doctors are supposed to do for quality care of patients?

or is the point that because the insurance companies have doctors jumping through hoops that quality care will be a thing of the past as they are more and more rushed?

It makes me uncomfortable though because I feel like the future may be for physicians to survive financially that there will be 2 classes of patients. the concierge patients and the less important patients. It both scares and saddens me.

My doc reassured me I was still his pt and I can't imagine him treating me as less worthy than another.

Maybe I don't understand the program... or the struggles physicians have.

Healsa site states:

"Devotes ample time and focus to each patient.
Appointments on the same or following day"

"Knows your health history, thinks proactively about your health future. Seeks the cause as well as treating the symptoms."

"Actively guides you towards all the right solutions to maximize your whole health and well-being, in an integrative and preventative manner."

I have always felt my docs did this already.

"No more barriers.
Can be reached during off-hours and contacted directly."

One group I see is excellent with this and while I would always prefer my doc, I know I will always get one of the docs on call. I LOVE knowing that the people that care for me/know my case are accessible. This group is just amazing with quality care/follow up, etc.

My other doc is not as accessible and have gotten docs from another area because he works out of the county and so in his practice ..this might be a major difference.

But I always get scheduled in quickly. He's been wonderful with me and I can't imagine anything less.

The HEALSA way *is* what I receive from my docs... without having to pay 150 a month. Except for a minimum half hr appt. Docs are rushed. Although ..again ..mine are awesome and spend time when they can. I am the friendly, chatty patient and I do wish I could talk with them more. I guess I am the doc's nightmare pt though given what I am learning about their time constraints. I guess it's true ..the day of Dr Welby is dead or a dying breed. Sad and frustrating though.