If you asked them, most doctors would tell you that they went into medicine to help people. To work with patients – not paperwork. But our modern medicine and insurance systems choke medical practices with mountains of forms, oceans of reports, and other administrative tripe.
These bloated back-of-house systems aren’t some minor annoyance. Study after study shows that they have profound negative impacts on doctors and patients alike.
- They lead to physician dissatisfaction and burnout, especially in already problematic shortage areas such as primary care.
- They require doctors to see high numbers of patients to keep their practices open, leading to physicians having, on average, ten minutes per patient visit.
- They clog up already too-short visits with questions and counseling points that may have nothing to do with the patient or his or her needs, but which doctors cannot skip without potentially forfeiting reimbursement for the visit altogether.
- They create unpredictable and unstable income situations which doctors juggling high medical school bills or the costs of launching a practice can ill afford. This directly results in increased burnout, a bias toward choosing specialty work (e.g. surgery) over desperately needed fields like primary care, and drives many doctors out of the field completely.
Short, rushed visits and high patient turnover causes its own cascade of costly problems.
- It prevents the formation and maintenance of the physician-patient bond, which is documented to improve all aspects of both patient and doctor satisfaction and compliance.
- It robs doctors of the opportunity to engage in highly effective techniques such as motivational interviewing. This increases the risks of misdiagnosis, negative drug interactions, negative health outcomes and escalation of medical conditions that could have been prevented/addressed early. It also reduces the likelihood of patient compliance.
- It can result in patients spending weeks waiting to see a doctor about non-emergency conditions, with all the attendant problems that causes.
While Americans are taught that this is just “how it is” or that it is somehow necessary, some doctors are moving to a Membership Medicine Model.
At its base, membership medicine is simple: patients pay a set fee each month for 24/7 access to a core set of services. Additional services are available a la carte as needed at set prices.
In many ways, it’s not unlike membership to a gym, yoga studio or even a Community Supported Agriculture (CSA) share or subscription food delivery service.
Patients know exactly what they will pay upfront and can confidently access services as needed throughout the month. Some patients continue to carry high-deductible health insurance plans to help cover major, unexpected expenses such as emergency surgeries or major injuries. Others find financial relief in ditching costly insurance payments in favor of a lower monthly payment and a separate emergency fund over which they have total control.
Doctors gain a consistent, reliable income that enables them to ensure their bills will be paid and free up their schedules to spend real time with their patients. They enjoy the personal and professional benefits of being able to dig deeper into personalized care and reaping the benefits of a strong doctor-patient relationship. Many also use their newfound freedom to offer services like house calls to housebound, fragile or high-risk populations.
To no one’s surprise, the insurance industry is not amused by this innovation – nor or they impressed by the onslaught of positive results patients and physicians report. It is telling, however, that their dire predictions and dour dismissals all lead back to the same place… money. The Membership Medicine Model saves physicians and their patients money and offers them an escape from the insurance industry’s monopoly on care.
I would never argue that any one system is perfect. But I think there is a lot more value in a system that supports the health, wellness, and success of doctors and patients than a system that supports the wealth and control of the insurance industry at everyone else’s expense.
So keep your eye on the growing Membership Medicine Model of care, and think about whether it might be right for you now or in the future. And if you happen to see articles, talking heads, and other media spewing hate about it, do me a favor – ask yourself whose best interest that source has in mind… because I’d bet good credits any day of the week it isn’t yours.