I fired my doctor few weeks ago. The reason has a lot to do with what’s wrong with our healthcare system today while the new doctor I hired has a lot to do with what could be right with our healthcare system.
I write a lot these days about something called a “patient-centered medical home.” It enables patients to access care when needed; communicate in a variety of ways with their physician, including email; and be treated as a partner in their healthcare rather than a subservient patient—subservient to the doctor, of course. In a patient-centered medical home, your medical records are accessible, typically on line, and all test results are communicated within 24 hours of receipt.
I’d been seeing an internist in a small private practice for the past six years. He practiced with his wife, a family practitioner, who saw our kids. Initially, all was good. I could get appointments as needed; was treated respectfully; and received good care. But gradually I began to notice that it was harder and harder to get in to see this doctor during the week—often because the office was closed. I became frustrated when I couldn’t communicate with him except by playing phone tag. There was not even a way to leave a voice mail unless it was for a prescription refill. And despite the fact that the office was computerized, and all my records were online, I had no access to them.
I also could not email my doctor. He said it was for security reasons but, since I write about this stuff all the time, I know how easy it is to create a secure email system.
The final straw was access. Over about two months, my two teenagers and myself had acute illnesses. Each time I called my doctor’s office for an appointment, and each time was told the office was closed (this was during regular business hours) and to go to urgent care. No one was even covering his patients. Each urgent care visit cost about three times as much in copayments, not to mention how they interfered with the continuity of care that is an important part of any primary care relationship.
That’s when I fired my doctor. Not because he was a bad doctor; but because he did not create a patient-centered home.
The irony is that this doctor’s practice is part of a large healthcare organization in my region that touts its “patient-centered focus.” I’d say the marketing people need to go visit their physician practices and see if what they’re advertising is actually what they’re selling. They might be for a surprise.
So I found a new doctor in the competing healthcare network. When I called and explained that I wanted to move myself and my family to the practice, but that I was currently sick, the receptionist immediately gave me an appointment for that day.
When I arrived for my visit, filled out the required paperwork (which, by the way, I could have done online), and my new doctor, he was able to access all of my records from the urgent care center because it was in same network.
Let me tell you. . .I was just thrilled with this doctor and his practice. I was thrilled with how he spoke to me, his unhurried manner, the way he listened, and his excellent communication skills. He didn’t interrupt, he didn’t appear rushed, he asked open-ended questions. Then, when I left the office, I was handed a slip of paper with a code on it. This was my code to access my medical records online. Now I can view my test results at the same time as my doctor. See every prescription I’m taking or have taken. Even set up appointments online.
Plus, if I have to go urgent care at night or on weekends, or am admitted to the hospital, all will have access to the same records. And, on those rare occasions my doctor is not available during the week, there are three other physicians who can see me, all with complete access to my medical history.
But the best part of this practice? I can email my doctor. I did just that a few days after our first when I still wasn’t feeling better. “Should I be concerned?” I emailed. “ I’m still not feeling better.” Two hours later, I had a reply.
I’m now in love with this system and the potential of patient-centered care. My only hope is that everyone out there can find a patient-centered medical system like mine. Sadly, however, I know that they are far too rare. Hopefully, as we move through healthcare reform towards a system built more on quality than quantity, more Americans will have access to this type of healthcare.