I had an amazing day on Friday. It started with a phone call from a local physician, one who I have never seen as an outside-the-box thinker, who was very excited about my transition to a direct-care model of primary care. He feels much of the same frustrations as me, and thinks my approach to the problem is intriguing. He asked me lots of questions--many of the ones I keep asking myself, actually--and had some good thoughts on the answers to some of these questions. Apparently, there is quite a buzz around town about what I am doing, and most of that buzz is positive. That's quite reassuring.
Then I got an email from a local business, asking me if I would consider being the doctor for their 100+ employees. I spoke to them on the phone and was very much encouraged by their insight and enthusiasm. They have seen their costs of insuring their employees go up dramatically over the past few years (as have all businesses, including mine), and are looking for a way to tame this cost.
They were even more excited about the possibility of working with me when I pointed out two things they didn't realize:
1. That a contract with my type of practice would, along with a high-deductible insurance policy, qualify them for the requirements of the Affordable Care Act (thus avoiding the fines), and
2. My focus on care on the continuum (care outside of the office between visits) would have a potentially big impact on reducing absenteeism. This is exactly what I was dreaming about a few months back when crystalizing the ideas of my practice, so the reality of having an employer contact me about this is incredible.
The coup-de-grace of my amazing day came in the evening, when I had dinner with a large group of my patients who belong to a Christian "community." This community has been very supportive of my practice for years, and has been even more excited with my new direction, as it speaks to their belief of community.
I was greeted with hugs and handshakes, handed a glass of wine, and directed toward pots of gumbo and lentil soup. The fellowship was loud and joyful, with updates on the health and life status of community members not there. Despite the fact that the group filled three rows of tables in this large living space, they apologized for the small turn-out. I smiled.
I was peppered with questions about the nature of my practice, what it would cost, and how it would work in comparison to my old practice. My answers were met with nods of understanding, and more questions. They were very happy with the answers I gave, and made it clear that they wanted to be on my list as early as possible. Then, one by one, each family recounted some way in which my care had impacted their lives: a child diagnosed with attention deficit disorder who was actually having petit-mal seizures, a quick discovery of an electrolyte imbalance in a mentally retarded child, the diagnosis of leukemia in another.
Tears were in everyone's eyes, including mine. What a privilege to not only know these people, to fellowship with them, and to consider them friends, but also to have really made a difference in their lives with my care. This is why I went into medicine, and this is why I am starting my new practice: to spend my time touching lives and making a difference.
In the aftermath of this momentous day, my sense of urgency has greatly increased. It's as if I have been overwhelmingly voted into office, given a huge vote of confidence for the campaign promises I've made, and now am met with the hardest part: to deliver the goods. It's one thing to say I am going to do something; it's a whole lot more to do it.
I don't want other doctors simply impressed with my ideas; I want them to be impressed by what I've done. I don't just want companies signing up for me as their doctor; I want to save them money by keeping their employees healthy and at work. I don't want people to love me for what I've done for them in the past; I want to do even more for them with my new practice.
This is the big difference between writing about change and doing it. Yes, my financial future and the success of my business depend on my ability to deliver the goods, but my big day showed me that this was much bigger than a business.
At the end of the dinner on Friday, one of the community members asked me directly, "Is there anything we can do to help you? We have people who can hang wallpaper, pound nails, whatever you need. You know we are all praying for you, but is there anything else we can do?"
I smiled, and said, "This dinner alone has done more for me than you can imagine." Then I thought for a moment longer, seeing that the offer was an earnest one, not simply a token offer of support. "I will think about it. Right now I've got a bunch of ideas that are forming something concrete, but I'm not there yet. But I know that to turn down a sincere offer of help is to take away the blessing of generosity, and I know you really mean it when you say you want to help."
My answer was met with a big smile and a long hug.
After taking a year-long hiatus from blogging, Rob Lamberts, MD, ACP Member, returned with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind), where this post originally appeared.