State of Primary Care

A lot has changed in medicine in the past fifteen years since I left residency and started to work here in Los Gatos. Our healthcare system is failing our patients as it has gone away from private practice and small groups, as more doctors have either joined large multi-specialty groups or retired. With few alternatives, more patients have joined these large groups, however, the number of doctors has not increased as fast as the patients have joined. Add to the increase in patient volume, there also has been an increase in administrative paperwork from insurance companies and an increase in charting that is required in electronic medical records systems. Because of these changes, patients are becoming frustrated and healthcare providers are burning out and leaving medicine at record numbers. I knew for myself I needed to change the way I practiced medicine.

In the traditional healthcare setting, there is just not enough time to be able to fully give the personalized care each patient truly deserves. It is normal for doctors to be responsible for the care of 2500-3000 patients, and only have 10-20 minutes to see each patient during an office visit. Also, in large groups, there is a lot of cross-coverage when other doctors are out of the office, further increasing the burden on the provider and taking time away from patient care. The groups have started using call centers, leading to long hold times when calling into the office, as well as protocols that create barriers to patients contacting their doctors directly, making medicine less personalized. A lot of the responses are impersonal and generic, leading to patient frustration and dissatisfaction. Our system is becoming more of a relationship between the group and the patient, instead of the primary doctor and the patient. It is becoming very difficult to see your primary care doctor promptly, and it may take weeks for a regular appointment or months for a physical. Because of this, most of the time patients are seeing the first available doctor, which is leading to more disjointed care and lower quality of care. Our healthcare system is more of a reactive system, instead of a proactive system. The best care is given when a patient has one primary care doctor that has adequate time for discussions on healthy lifestyle, disease prevention, and chronic disease management. 

I chose concierge medicine because I no longer wanted to compromise the care I provide because of a system where groups and insurance companies are placing too many restrictions and roadblocks to quality health care.  Concierge medicine will allow me to get back to what medicine should be, the primary care doctor and the patient working together, being proactive while focusing on prevention and wellness. The roadblocks put in place by large groups will be removed, and patients will be able to reach me directly by text, electronic messaging, or telephone 24/7. I will be able to provide excellent care to a few hundred patients, instead of being spread thin over thousands of patients. Appointments themselves will start on time and last longer, allowing for all topics to get covered. I love being a family doctor and caring for patients and their loved ones over a long period. I am very excited about this new chapter in my career, and to be able to provide the level of care that each patient deserves.