Bringing Back the Disappearing Doctor: time has changed medicine
Giving Control Back to the Patients
by: Crystal Barber MBA & Heather Morse MS, ATC, OTC
There’s little doubt that the front line of medicine — the traditional family or primary care doctor and the patient relationship— has been under siege for years.
Choice is what we all want, as most would say. There is a growing cognizance that patients can and should play an important role in deciding their own care, in defining optimal care, and in improving healthcare delivery. There is much growing evidence that engaging patients in treatment decisions and supporting their efforts at self-care and preventative care, can lead to more beneficial long-term outcomes. Patients who are active participants in a shared decision-making process have a better knowledge of treatment options and more realistic perceptions of treatment effects.
The resulting treatment choices are more likely to concur with their preferences, lifestyles, and attitudes to risk. Actively engaged patients are also more likely to adhere to treatment recommendations, and less likely to select expensive procedures.
The Modern Primary Care Model
One would assume all of the above benefits would shape a modern, successful model of healthcare. Yet this is not the model patients are exposed to in this modern era. Higher healthcare costs, skyrocketing drug prices, and lower reimbursements for physicians have created an environment that does not support a patient-centered model of care. Doctors are working under more pressure than ever before. Recent changes in health care – such as ramped-up productivity requirements, increased documentation, and new quality metrics have left physicians scrambling to see more patients on a daily basis to cover rising supply costs, higher malpractice rates, and increased staff costs. Even so, patients deserve their undivided attention. These conditions have many patients feeling dissatisfied by the quality of the office visits with their physicians due to time restraints and longer wait times. While the ballpark office visit time is about 11-15 minutes, patients are not getting as much time as they need to address healthcare concerns. By all accounts, shorter visit times take a toll on the doctor-patient relationship and may represent a missed opportunity for getting patients more actively involved in their own health. There is less of a dialogue between patient and doctor, studies show, increasing the odds patients will leave with a prescription for medication, rather than a behavioral or lifestyle change — like trying to lose a few pounds, going to the gym, or electing alternative for pharmaceutical treatments.
What We Can Learn From Old School Practices
The term “old school” in many facets of life has negative connotations. We live in a modern, technologically advanced and fast- paced world — and there’s no room for things that hold us back.How did we get to the stage where a genuine and caring doctor has become the odd one out? The old school physician pulled up a chair, took the time to sit face-to-face with their patient, maintained eye contact, and asked open-ended questions. They allowed the patient to express genuine healthcare concerns, directing them when necessary towards the questions that need to be asked to benefit them as an individual. It included some good old-fashioned talking and learning about the patient’s lifestyle and choices. At the end of the encounter, they were given a chance to ask any questions, offered education, and given multiple treatment options. In the former healthcare era, herbs and alternative medicine treatments were offered along with education to help the patient understand all the options available. The treatments were then used in conjunction to offer the patient the best outcome possible. The modern era of medicine has lost some of the key components that made medicine successful in the first place. Methods like house calls and alternative forms of medicine offered patients options to get involved with their healthcare, alternative medicines that would not cause additional addiction and further harm the body, and face to face time to be educated and heard.
“In 1930, about 40% of doctor-patient interactions were performed through house calls, but by 1980, the rate was down to only 1%.”
Physician House Calls: An Old Model with a Modern-Day Twist
The concept of a doctor coming to a patient rather than a patient going to a doctor is hardly a revolutionary concept yet could be the answer the modern era of healthcare is looking for. In 1930, about 40% of doctor-patient interactions were performed through house calls, but by 1980, the rate was down to only 1%. We now live in a time of convenience and speed. We have grown so accustomed to instant information, feedback, entertainment and more, that we’ve grown impatient with waiting. This transition to an easy access and fast pace life has actually helped to bring back the nostalgic house call.
“The new era has also brought the ability to reach information quickly about better healthcare choices that are now being offered to patients via concierge medicine. While we want instant access to our doctor, we also want more time with them to discuss all of our health and wellness concerns.”
A New Spin on Healthcare for Your Lifestyle
The young adult population is very tech-savvy. They are accustomed to using apps and quickly scheduling appointments with a few clicks. They are also very busy working and caring for young children, so a model that doesn’t require them to leave their homes when they have a sick child is very appealing. The search for affordable, convenient healthcare has now brought advancements such as tele-med visits and house calls to the forefront. Patients want healthcare options that suit their lifestyle and are of a higher quality of care. Patients are now seeking out practices that offer not only technology based patient interaction for more affordable rates, but also practices that offer a more patient-centered approach. Services such as house calls and same day telemedicine visits from the comfort of their own home are now what patients are seeking the most.
Traditional Medicine Concepts Meet New Age Lifestyles in North Alabama
Old school traditional medicine concepts work. These concepts help patients feel more at ease with treatments, obtain better long-term outcomes, and cut individual healthcare costs. With this knowledge and experience in mind, the owners of Traditional Family Medical Center will open its first location in Huntsville Alabama, in late March 2020. The vision started with traditional family medicine concepts and has grown to include a long list of services including holistic, integrative medicine. This service puts patients at the forefront of their healthcare again. Traditional Family Medical Center offers patients the choice of conventional pharmaceutical treatment options as well as an avenue where patients can choose to treat illnesses with holistic options. Their goal is to truly get to the root problem and not only manage symptoms but work on a reversal of the problem. One very valuable service that will be implemented is telehealth, whereby providers use email, phone, text, or video for consultations, reducing the need for time-consuming in- office visits.
However, TFM does not fall into the trap of all-or-nothing thinking, expecting patients only to see their providers either in the office or remotely. With a little creativity, we can envision mobile health technologies such as telemedicine leading to the restoration of an almost forgotten medical tradition: The House Call. Imagine the connected provider traveling to patients as needed, with a portfolio of cloud-enabled diagnostic, therapeutic, and decision-support tools at their disposal. Blending the importance of conventional medicine, as you know it today, with the proven results of traditional (the old ways) we can truly bring healthcare back to the patient. Simply managing treatments is no longer acceptable for many in our population. Patients want answers, they want options, and they want to know they are being heard when they voice their concerns.
You can learn more about Traditional Family Medical Center on their website
Crystal Barber, MBA, is a co-owner of Traditional Family Medical Center & Heather Morse MS, ATC, OTC owner of Salt on the Rocks and co-owner of Traditional Family Medical Center