Month: October 2010

A 48 year old male patient, Mr. CS, came to see me with a complex problem which included feelings of depression, muscular twitching, weakness, fatigue and periods of memory loss. He has been a highly successful real estate business man but because of his illness, he was a risk of losing his job. He called me on a Saturday on my cell phone and related his complaints. After I heard his predicament, I logged onto my office computer from home and immediately scheduled him for a Monday appointment.

Upon his Monday visit, I was able to spend enough time examining him and formulating a diagnostic plan which was to see a neurologist as soon as possible. The wait time in my area for neurology consults is over 7 weeks. While CS was in my office, I called my neurologist colleague and pressed for an expedited appointment over the next 48 hours. I emphasized to the neurologist that I knew this man and something was definitely going on which needed rapid diagnosis and treatment. By the end of the week the patient had a diagnosis. Mr. CS had a history of multiple concussions while playing sports. His EEG revealed a form of epilepsy most likely related to multiple concussions. He was placed on anti-epilepsy medications and within two weeks he was much improved and able to work and focus.

The point of this example of Nu-Living Concierge Medicine in “real life” was the various ways the program allowed me to rapidly help CS. First, he was able to reach his personal physician by phone on a weekend. The Nuliving electronic medical record system allowed me to access my office on the weekend to schedule an appointment immediately. The limited member patients I see allowed enough time for me to thoroughly evaluate his case and to personally call and appeal to the neurologist for an expedited appointment. Finally, because I knew CS, I recognized that something very serious was occurring, an unlikely scenario in situations where patients see multiple physicians and don’t have one who really knows them.

Big changes are occurring in today’s healthcare environment and physicians already are finding it very difficult to practice high quality personal medical care. The adult primary care specialties of Family Practice and Internal Medicine are in grave jeopardy of becoming extinct. Years of declining insurance company and Medicare reimbursements, skyrocketing practice overhead and ever increasing red tape have led to a major shortage of primary care medical doctors as the current generation is shrinking due to physician retirement and the lack of interest on the part of young physicians to go into primary care. As a result, patients are experiencing more difficulty finding a primary care doctor, waiting longer for appointments, and visits have become shorter and rushed as doctors are forced to see more patients in an “assembly line”, impersonal fashion. Needless to say this is not good medical care for patients who need more time with their doctors.

A 2007 Primary Care Survey conducted by Merritt Hawkins found huge majority of Family Practice and Internal Medicine doctors believed that a severe shortage of primary care doctors will develop in 5-10 years because of lowered reimbursement and administrative hassles.