In 2015, I walked away from insurance-driven health care to open Unorthodoc, a primary care practice based on individual and family memberships. I was pretty sure that I knew why my current and potential patients would join me. After all, weren’t they as tired of the inconvenience and cost of insurance-controlled medicine as I was? They wanted my unhurried time, believing that a doctor who heard their entire story would order fewer prescriptions, tests, and referrals…right? Surely they would flock to pricing that was extremely transparent while also being less expensive than their cell phone. And they’d love using available technology to have a “doctor visit” without always having to actually appear in my office. I just knew it.
The model struck a chord with enough people to get us off the ground. But when the early adopters told others about Unorthodoc, new patients started showing up on the strength of a single concept that had escaped me. While I was introducing the practice using words like “sensible,” “flexible,” and “affordable,” our patients were broadcasting something they valued even more – their new doctor was “accessible!”
Two new patients signed up because they were present with an established member on a holiday weekend and witnessed us troubleshooting a child’s sudden asthma flare by phone instead of going to an urgent care. On a recent coffee date with friends, a member securely texted a question to us and got his answer before their cups were empty. His friends signed up the following week. Someone walked in to join Unorthodoc one afternoon after calling the office the same morning. I answered the phone because the patient care coordinator was busy drawing blood. “Sensible,” was my thought; “Accessible!” was hers.
It seems people desperately want to talk to their doctors yet get the opportunity too rarely. If typical doctors made themselves as available as I am to a 2500+ patient panel, it would simply shred them. First, they would go broke and then they would go crazy. The insurance industry rarely pays for contact outside of face-to-face office visits. Therefore, doctors need layers of people to protect them from “unpaid” contact, keep their schedules full, and bill the “payers”. They have neither the time nor the economic incentive for simple communication.
However, I chose the direct primary care model because it keeps patient rosters between 600 and 800. It bakes in the time needed to form relationships and has already been proven to yield tangible savings in time, money, and health. But its unsung benefit is why I don’t fear being abused by people who are essentially paying Unorthodoc for near 24/7 access. When people trust that I’m there when they need me, they carefully consider how and when to “bother” me. Not only are patients drawn to “accessible” — their trust is why it’s even possible. Consider me schooled!