Islon Woolf MD
Concierge Medicine and direct access
Updated: Jun 28, 2020
Direct access is having the ease to communicate and meet with your doctor without a go-between or subordinate, such as a physician assistant, medical assistant, secretary, or answering service. Having direct access to your doctor is more than just convenient, it leads to better outcomes. Direct communication ensures less errors are made, and more timely communication leads to prompt diagnosis and treatment.
Lack of direct access
However, patients nowadays seem to have less access than ever. It is hard to get call-backs from doctors, appointments with doctors, testing, and appointments with specialists. Why?
1. Shortage of primary care physicians. Over the decades primary care has become a less popular career choice for medical students. Many residency spots in primary care are left unfilled. This is may be due to pay disparities between primary care and the specialties. It has been estimated, by the year 2032, there will be a shortage of between 21,000 and 55,000 primary care doctors in the US. The shortage of primary care doctors leaves the current pool of primary care doctors to pick up the slack.
2. Increasing complexity in medicine. Our current increase in lifespan carries with it an increase in chronic disease. We have more technology than ever before to diagnose and treat these diseases, but it take an army of professional to organize and implements all the testing and treatments. A doctor may see the same number of patients a before, but each patient requires much more time and care.
3. Increased clerical work for doctors. Doctors are overwhelmed with demands from insurance companies, electronic health record documentation, and billing. Doctors now have less time for direct patient care. Every one hour spent in direct patient care generates two hours of chart work. After working a 12-14 hour day, physicians spend an additional 2-3 hours at home, working late into the evening in what we would call “pajama time".
4.. Work delegated to staff. It is hard to get doctors on the phone because they delegate part of their job to their staff. Doctor's hire physician assistants, nurse practitioners, and medical assistants to handle medical issues and prescriptions, and hire scribes and secretaries to handle phone calls and records.
5.. Office staff overwhelmed. With decreasing reimbursement, doctors run their offices with minimal staff to save on overhead. This staff becomes easily overwhelmed. This leaves little time for what is really important - coordination of patient care. Making sure patients have appointments with specialists, test are ordered and followed-up, treatments are ordered and follow-up, rand records are retrieved and stored in the chart.
In summary, patients have less access to healthcare because fewer doctors, are expected to do more, on more patients, with less resources. They are being squeezed from both ends.
Concierge Medicine and direct access
My practice is small. I typically see only two to four patients per day in my office. This gives me ample time to attend to your needs. I do not have to delegate work to my staff. I can help you with a tasks as small as calling in a prescription, or task are big as helping you diagnose a complex medical problem. This direct communication between you and me leads to fewer errors. (To read more about ensuring accurate diagnosis and treatment in Concierge Medicine, click here.)
There are no barriers to communication. You can contact me directly and when it is convenient for you. I keep my cellphone on 24/7/365 - even on vacation. In case I am not available, my office is always overstaffed, and I work with four other Concierge Medicine doctors that cover me. There are no barriers to appointments. Same-day appointments and even house calls are offered. Your problems will always be addressed promptly to ensure timely diagnosis and treatment.
There are no barriers to communication. There are no barriers to appointments.
When it comes to access to testing and specialist outside of my office, I can help you navigate the cities many resources. I have practiced medicine in Miami for 25 years. During that time, I have been able to vet the institutions and specialists that provide the best care. I have cultivated close relationships with those who excel. Additionally, my office staff is available to assist you with appointments for testing and specialists. They will work with you until you are taken care of. For example, if you need an MRI urgently, my office will contact the many diagnostic centers across town until we find one that can take you at short notice. Regardless of your problem, access is important. The faster you communicate it to me, and the faster we work it up, the better your outcomes.
Regardless of your problem, access is important. The faster you communicate it to me, and the faster we work it up, the better your outcomes.