(Go to News to see some developments in a note sent recently)
My Dream
For eight years
in Point Reyes, I practiced medicine the way it ought to be
practiced. I treated
four generations of families.
I not only knew my patients’ names, diseases, cadre of
medicines and insurance companies, I also learned what they thought,
who their friends were, who would be there when they got sick, how
they felt about end of life.
When a young girl came in for her first pap smear, I became a
part of her support network as she blossomed from teen to adult, so
that years later when she came in pregnant, we already had a rich
bond. Still later, when
her child was sick, she followed my instructions with confidence.
I had similar bonds with all my patients, making difficult
medical situations go smoother by virtue of this trusting
relationship. When a
neighbor brought in an old man whom she did not think ought to be
driving anymore, my day-to-day presence in both of their lives as
their physician, allowed me to examine my patient, maintain his
dignity, do the right thing for him in my recommendations to the
DMV, and perhaps most importantly, figure out who in our community
would take him to church and the barber.
There is no
question this is the best medicine, yet practicing this way, I was
unable to make a living.
Insurance companies pay forty or fifty dollars for a pap smear or a
dementia examination, but they do not pay for the time it takes to
call a young mother at the end of a busy day to ask after her child
or to arrange a family meeting to discuss taking the car keys away.
Caring about patients is systematically filtered out of
insurance company reimbursements.
In this way, a good physician is financially penalized for
taking time with her patients.
Health hinges on the doctor-patient relationship.
With the insurance companies running the show, neither I, a
doctor, nor my patients are happy with the current system.
We need to make a change.
If medicine is to be a business, we need to do what all good
businesses do: Remember
to listen to the customer. After
eight years of practicing primary care medicine, I know that
patients want a doctor who is there for them during a time of
crisis, a doctor who engages in a trusting relationship and a doctor
who knows as much about who the patient is as what disease the
patient has.
We need a system that incorporates this need back into health care.
My website is just a beginning.
I am eager for your interest, input, feedback and critical
connections to make my dream come true for all of us.
At times I may ask you for letters to bring to important
decision makers on both a local, state and national level.
The only way the system will change is if your concerns are
heard loud and clear.