Assembly Line Medicine

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Do you remember the “I Love Lucy” assembly line episode?

Lucy and Ethel are working on an assembly line, wrapping candies. At first it’s easy. Then the candies come faster and faster, and the humor starts.

That’s what the traditional medical world seems like, from a doctor’s perspective (without the humor). You’re expected to see more and more patients, barely having time to think and interact. If you manage to do a decent job, you’re handed more work.

Insurance is calling the shots. They decrease reimbursements, while coming up with esoteric tasks to reportedly gauge whether you are doing your job well. Things like x% of diabetic patients need to be on a statin, or x% of Medicare patients need to have their annual wellness visit. If you hit those metrics, you might get a bonus from the insurance companies. The goal post is often changing.

And where does that leave the patients?

Almost two years ago I left my traditional medicine Family Practice. I started the area’s first DPC (Direct Primary Care) practice. Patients pay a monthly fee, and in exchange they get essentially unlimited office visits and communication. I don’t bill insurance, so I don’t have to check the required boxes. I spend 30 to 60 minutes with most patients, and I have office visits available the same day or next day if needed.

I have only one full-time employee. Patients have direct communication with both of us. I love this way of practicing medicine. It’s like a breath of fresh air for my patients and me.

Working for my patients, rather than for the insurance companies.