This crazy, jump off a cliff, risk taking adventure of starting my own clinic is working. It is so much better. The things that frustrate the heck out of you about our medical system largely don’t exist here. The waits and the miscommunication and the lack of followup dissolve with better access to your physician.
Today a patient called me frustrated that he could not fill his wife’s medication early because she was titrating up the dosage rapidly (as instructed). He already has the stress of caring for a sick loved one, and now he is feeling like the pharmacy tech is not treating him kindly. The insurance company would not fill the medication because according to the prescription they had on hand, he should not have run out yet.. All he needed was a new prescription from me and the problem was solved. He called. I picked up. She now has her medication.
Another patient texted me because the infusions she was receiving were painful this time around. What could be done? A quick call to the pharmacist was all that was needed to assure she would get a diluted version the next time around. No waiting on hold. No middle men.
This is what sets us apart from traditional practices. We have TIME.
Yesterday I learned that a patient who has been on blood pressure medications for over two years takes a supplement that is likely contributing to his difficult to control blood pressure. “Why didn’t you ever tell anyone about this?” I wondered. His reply? “No one ever asked”. I had the time.
A few weeks ago when I asked another patient what was her motivation to start a new exercise program, do you know what she said? She wants to get fit and be healthy so she can feel strong and independent enough to leave an abusive relationship. I was shocked. This absolutely central fact of this woman’s life would have been otherwise unknown to me had I not had the time to ask and listen.
Yesterday I spent thirty minutes consulting with a psychiatrist at the University of Washington. This is an amazing, free service to any healthcare provider in Washington state. I had never used it before. I didn’t even know it existed because I never had the time to seek it out. Local psychiatrists I had tried to call in the past simply did not call me back. They did not have the time.
In medicine we know to ask about supplements. We know to ask about domestic violence. We know to educate about vaccines and we know how to help people follow through on treatment plans. We just don’t always have the TIME.
Here are some more things I did this week because I had time. I visited a hospice patient at home and mourned with her husband. I took calls from physical therapists and assisted living nurses. I spoke to them directly about our patients. I spoke to ER doctors and hospitalists directly to help coordinate my patient’s inpatient care. I know exactly what is happening with my patients, and it is so much better for their continuity. None of this work would have been compensated for in the fee for service world, and therefore it would have been squeezed out.
I also started the process of getting an exercise intern in the clinic to help give (free) personalized exercise plans to my patients. If this works out, I see no reason I cannot do the same with a psychology student or a nutrition student. We have this amazing resource that is WSU right in our backyard, and I have never used it, because I did not have the time.
I have so many more anecdotes like this. And I have no doubt that those who are reading this have many stories of frustration that could have been avoided or solved if they had better access to their doctors. I am so thankful that I took the step off that cliff, and I am thankful for those that are supporting me along the way.