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Time Is On Our Side (Once Again) | Jan 7, 2015

Dr. Barry

I have just made the biggest change in my medical practice ever. I feel like I am waking from a long slumber where doctors are struggling to work harder and harder for less, and professional morale is at an all time low. A company called Signature MD helped to rouse me from my professional lethargy, and once again I am excited at the prospect of being able to deliver even higher quality health care than I am now. I will have a chance to really practice at the top of my game. Once again I think I will be able to really make a change in people’s lives. I am excited about finally being able to make a difference.

I’m also nervous because this is a fundamental change in my practice. I am adopting a Personalized Care Program in which a limited number of my patients will receive enhanced services, more detailed management of their health and wellness, and a focus on Preventive medicine.

At the core of this new program is time. I’ll have more time to devote to each patient. In effect, I’ll be acting as their Life Coach.

I really don’t have a better term for it yet, but I think Life Coach conveys my intent. Any good healthcare provider, and we have many in Syracuse, can handle your blood pressure, your diabetes and your sore throat. This is midlevel provider stuff, which is important but doesn’t need my skill level. I want to actively follow a smaller number of patients and really provide them more oversight and attention.

Frankly, we all should have this kind of relationship with our doctor, but we will never have it without a program like the kind offered by Signature MD. The healthcare system has been changed into an assembly line with a different healthcare provider for each visit, not enough time allowed for meaningful consultations, and where the standard of care has devolved to some pills, some tests, and then it’s on to the next patient in line.

Walmart says they want a healthcare clinic in every store and want to be the number one provider of medicine in a few years. You don’t have to scour the national news for changes in health care. Look at what has happened to North Medical Center. Clinics aren’t bad…but I don’t want to practice assembly line medicine. Signature MD’s Personalized Care Program will give me the opportunity to spend quality time with patients, including the time to follow the patients when they are hospitalized at any of the local hospitals.

When we doctors turned over your hospital care to Hospitalists (in-house staff healthcare providers), it was a good for the doctors but really not so good for the patients. As a patient, you want the medical professional that knows you best to see you when you are sick, whether that’s in the office or in the hospital. But it’s most important in the hospital when you are most vulnerable to mistakes and miscommunication. Signature MD will give me the time to manage all that and actually be there to assess you in person, and to communicate directly doctor-to-doctor with the physician charged with your care in the hospital.

Yes, there is a fee for all this extra service, but however, because I believe that the health of every single person that enrolls in the program will be improved, I think it will be worth the fee. I think your health is worth it. I think you are worth it. I realize that this program will not appeal to everyone. Some people won’t see the value in a sustained and engaged relationship with their doctor. Some people are young enough, healthy enough and or self-directed enough that they don’t really need the program. Some people simply won’t want to pay an extra fee. I don’t fault them for not taking advantage of this program, but I am hearing from a few people that are faulting me for working on being a traditional doctor again.

By “traditional” I mean having the time to really listen and establish a relationship with each individual patient. I have heard from and respect those who are opposed to this new program. However, I have been given an opportunity to fundamentally change my practice in such a way as to make me feel that I am actually making a difference again. What an opportunity. What a risk. But I just had to take it because the price – better health care for my patients and better job satisfaction for me – was worth it.

This will not be a one-size-fits all, cookie-cutter program. What’s important in healthcare differs from patient to patient. What’s obvious is that this isn’t being addressed in the world of 10-minute office calls. We are just bandaging the problem with these visits and not really focusing on what’s causing the underlying problem in the first place. I cannot get a person to quit smoking or lose weight with a couple of office visits. Complaints of anxiety, depression, insomnia or chronic pain are not treated with a pill and a referral to a specialist. We can do better than this…but we need more time.

The new Signature MD Personalized Care Program gives us the time we need to make a difference. This doesn’t mean that I will be making patients get more tests done. If anything, I could actually end up recommending less testing. Whatever testing that I do recommend will be accompanied by written explanations of all my suggestions as well as comparisons to the national guidelines.

Now, for those people who choose not to sign up for this Personalized Healthcare Program, there are still plenty of options in our office available to you. Starting next year all of my patients that choose not to sign up will be directed to my Nurse Practitioner Zoryana Bozak, who will handle all the routine office calls and physicals. She will be working directly with me and whenever your medical problem needs my direct attention, I will be there for you. If it is a routine visit, if it is a routine visit, you will see Zoryana. If it’s not routine, you still see Zoryana first, or another one of our excellent providers, who then will get me directly involved whenever the situation warrants it. If you feel you need or want to see a physician, we still have Drs. Knudsen and Manfredi taking new patients.

I didn’t get into medicine to see as many office calls as possible. I got into medicine because I enjoyed the intermixing of the sciences and dealing with people’s problems and personalities. I have lifted my head up from the din of visit-after-visit where I don’t know if I am making a difference to say, “Wait a minute. This isn’t how it’s really supposed to be. This way is not really allowing me time to change peoples lives.” There must be a better way. The new Personalized Care Program that I’m offering is the wake-up call to a better way. At last, time will be on our side.