As an emergency physician for 30 years, I provided care for thousands of acute medical problems — involving every specialty. Driven to be more ‘productive’, even my colleagues in Internal Medicine have adopted the myopic ER ‘problem-oriented’ doctor-patient approach. promoting good health and preventing new problems. Productivity dictated the change; doctor-patient interactions now average only nine minutes!
Certainly patients deserve a thorough conversation & evaluation to manage their medical issues and problems, but as importantly, they deserve broad surveillance to prevent new problems from developing. Patients also benefit by being fully educated regarding the problems they have and being aware of signs & symptoms that may indicate new underlying issues.
As importantly, doctors and patients should be free to navigate their decisions and chart their healthcare management free from the bureaucratic pressures and metrics dictated by private & government payors. Unfortunately, most doctors are constrained from performing diagnostic studies and initiating treatment regimens by ever-proliferating protocols that threaten their reimbursements; worse, threaten patients’ wellbeing! The River Med Spa model of contracting directly, doctor-to-patient, resolves such intrusions.
Does a ‘traditional approach’ imply avoidance of newer diagnostics and treatments? Emphatically, no! The characteristics of traditional medicine, including the sanctity of the doctor-patient decision management & thorough preventative assessments, are the ’traditions’ imperative to preserve. The ever-advancing diagnostic modalities which my work as an emergency physician routinely employs, are tools that can provide benefits to patients before problems arise.Modern medicine addresses problems, but fails woefully inAnother deviation from ‘traditional medicine’ worth distinguishing is weight-loss management; obesity is a major determinant for cardiovascular disease, sleep apnea & pulmonary problems, orthopedic disease, metabolic and dermatologic syndromes. Traditional methods seeking lifestyle changes have not worked and pharmacologic management is often required for meaningful weight loss and avoidance of its serious sequelae.
Our Preventative Medicine practice will be accepting only a limited number of patients to ensure optimal longitudinal care for our patients.