Direct access is having the ease to communicate or meet with your doctor without a go-between or subordinate, such as a physician assistant, medical assistant, secretary, or answering service. Having direct access to your doctor is more than just convenient; it leads to better outcomes. Direct communication ensures fewer errors are made, and more timely communication leads to prompt diagnosis and treatment.
Lack of direct access
Patients nowadays seem to have less access than ever. It's hard to get appointments, call-backs from offices, testing, and referrals to specialists. Why?
Shortage of primary care physicians. Over the decades primary care has become a less popular career choice for medical students. Many residency spots in primary care are left unfilled. This is may be due to pay disparities between primary care and the specialties. It has been estimated, by the year 2032, there will be a shortage of between 21,000 and 55,000 primary care doctors in the US. The shortage of primary care doctors leaves the current pool of primary care doctors to pick up the slack.
Popularity of Concierge Medicine. In big cities, more doctors are choosing the Concierge Medicine model leaving the remaining primary-care doctors to pick up the slack.
Increasing complexity in medicine. Our current increase in lifespan carries with it an increase in chronic disease. We have more technology than ever before o diagnose and treat these diseases, but it takes an army of professional to organize and implements all the testing and treatments. A doctor may see the same number of patients as before, but each patient requires much more time and care.
Increased clerical work. Doctors are overwhelmed with demands from insurance companies, electronic health record documentation, and billing. Doctors now have less time for direct patient care. Every one hour spent in direct patient care generates two hours of chart work. After working a 12-14 hour day, physicians spend an additional 2-3 hours at home, working late into the evening in what we would call “pajama time".
Work delegated to staff. It is hard to get doctors on the phone because they delegate part of their job to their staff. Doctor's hire physician assistants, nurse practitioners, and medical assistants to handle medical issues and prescriptions, and hire scribes and secretaries to handle phone calls and records.
Office staff overwhelmed. With decreasing reimbursement, doctors run their offices with minimal staff to save on overhead. This staff becomes easily overwhelmed and leaves little time for what is really important: coordination of patient care, making sure patients get appointments with specialists, tests are ordered and followed up, treatments are prescribed and followed up, and records are retrieved and stored in the chart.
In short, patients face reduced access to healthcare as fewer doctors are expected to handle a larger number of patients with fewer resources. They are under pressure from all sides.
Concierge Medicine and direct access
My practice is small. I typically see only two to four patients per day in my office. This gives me ample time to attend to your needs, making it unnecessary to delegate work to my staff. I can help you with a tasks as small as calling in a prescription, or as big as helping you diagnose a complex medical problem. This direct communication between you and me leads to fewer errors. (To read more about ensuring accurate diagnosis and treatment in Concierge Medicine, click here.)
There are no barriers to communication. You can contact me directly and when it is convenient for you. I keep my cellphone on 24/7/365 - even on vacation. In case I am not available, my office is always overstaffed, and I work with four other Concierge Medicine doctors that cover me.
There are no barriers to appointments. Same-day appointments and even house calls are offered. Your problems will always be addressed promptly to ensure timely diagnosis and treatment.
When it comes to access to testing and specialist outside of my office, I can help you navigate the cities many resources. I have practiced medicine in Miami for over 25 years. During that time, I have been able to vet the institutions and specialists that provide the best care. I have cultivated close relationships with those who excel. Additionally, my office staff is available to assist you with appointments for testing and specialists. They will work with you until you are taken care of. For example, if you need an MRI urgently, my office will contact the many diagnostic centers across town until we find one that can take you on short notice.
Regardless of your problem, access is important. The faster you communicate it to me, and the faster we work it up, the better your outcomes.
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