We seem to hear a lot in the news about "Healthcare". When I hear the news say "Healthcare for everyone", I cringe because we really don’t want Healthcare, we want Medical Care.

Let’s look at the differences between the two.

Medical Care has never been better.

Getting MEDICAL CARE means everything to you. Medical Care brings us new procedures, new remedies, new medications, and surgeries we never dreamed possible. Not to mention the vaccinations that are constantly coming out to protect us from disease and cancer in the first place.

And on top of that, we also have the incredible ability to prevent diseases like cancer when we never thought we could.  It used to be that your doctor knew everything about you.

We could talk to our doctors about anything for as long as we wanted. They found the solutions to what ailed us. This was the foundation of Medical Care.

Medical Care is a profession, an actual service and the trust lies between patient and doctor.

Healthcare has never been worse.

Healthcare is not a profession. It is a FOR-PROFIT business.

Healthcare is about administration costs, CEO salaries, insurance denials, and insurance premiums. It is a business that hires doctors, nurses, billing clerks, hospitalists, medical assistants, etc.

The one person who actually brings in the revenue for this company is the doctor, PA, NP.

The office visits and the orders they generate bring in the revenue. All others, from CEO salaries to nurses, maintenance, billing clerks, and ads are at the mercy of what these three people can bring in.

Let's look at these real-life examples:

Example 1: Exceptional Medical Care

Dr. A has her own practice.  She is not part of a healthcare system. This is called a "solo" practice. Her patient, Mary, sees her. She knows all of Mary's medical conditions. Mary always gets "same-day visits" or a phone call back from Dr. A. Office visits are 45-60 minutes on each visit with Mary. She knows Mary's family caregivers, too. This doctor has only a receptionist.

Here's the KEY: she runs her own practice. If Dr. A wants to spend hours with you, she can. Now she may take your insurance, which typically pays 10% of what she charges. (Don't we wish we could do this at the grocery store!) or Dr. A could take a monthly fee of $125/month from you.

Doctors who charge a monthly fee are called Direct Primary Care. This monthly fee is paid automatically, like a gym membership.  Mary can see, call, or text Dr. A as often as she wants. The fee is dependent on age, not phone calls, visits, or texts, and ranges from $18 to $150 a month. Dr. A will call in prescriptions and take phone calls because she does not need Mary to come into the office to be paid. Those are insurance rules and she does not take insurance. Mary still keeps her insurance in case she needs specialists or hospitalizations.

NOTE: Dr. A is not "concierge" medicine but a practice modeled after pre-insurance days called "direct primary care".  Concierge medicine doctors take insurance like healthcare doctors do.  The fees are typical $500 - $5000 a month. This gets you house calls or phone calls promptly returned. These fees are high in order to cover what insurance doesn't pay for his/her "regular" patients. 

Example 2: Questionable Healthcare

Dr. B works for a large healthcare company. He gets a salary (plus a "bonus" commission) for his production.  If he orders more tests, more procedures, sees more patients, he gets a bigger "bonus commission", but this is a "carrot" to get the doctor to produce more. He is required to see more patients and see them faster.  He gets "written up" if he doesn't do this. By seeing more patients, the logic is that he will generate more orders. In most healthcare systems, he is required to refer you to only those services within his own healthcare system.  

The office has a staff of 3-4 receptionists, 1-2 billing and insurance clerks, 5-6 nurses or medical assistants, one office manager, the boss who reviews everyone's evaluations, salaries and the people above the boss who make policy and profit for the company, the CEOs.

Therefore, he must work harder and longer to support all these employees in the company. Robert is a patient of Dr. B's. He waits 3-4 months to get in to see him because Dr. B must be booked to see 20-30 patients a day. Robert will see him for 6 minutes. Dr. B may order more tests, and ask Robert to come back for another visit. Robert will still pay his deductible or co-pays and his insurance premiums.

These "healthcare" doctors are burning out at an alarming rate. They didn't get into medicine to "chase the bonus carrot", but to help you.  Most of them have medical school debt, leaving them no choice.

Here are the resources: Why physicians burn out.  I find it ironic that the studies to prevent burnout are suggesting the exact thing direct primary care physicians already do.

Healthy aging seniors have personal doctors.

So you have three choices:  

• Find a physician who is in a solo practice, takes your insurance, and runs their own practice with a focus of putting you first. 
• Find a Direct Primary Care doctor in your area, and pay a monthly fee to get the time, trust, and care you expect. 
• Find a physician in your healthcare system who doesn't care about bonuses and spends more time with you and not on orders and a computer. (And hope they won't quit or get fired.)

If you are a senior who wants exceptional medical care then pick up a FREE copy of The Senior's Starter Guide.  On page 7, you'll find 11 very smart questions you should be asking about Medicare. After all, shouldn't we get the best?

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