Last week I had my first meeting with my new primary care doctor. He works with Qliance Medical Group here in Seattle. I cannot tell you how pleased I am with their services. I have already recommended here looking at what they do.
On March 26th, Dr. Garrison Bliss, who founded Qliance Medical, spoke to the Washington Association of Health Underwriters about the situation of healthcare in the US, and what to do about it. If you are concerned about healthcare, for yourself or for the nation, or for both, I strongly recommend listening to this talk. Listen here.
Bliss asks, Why do we have the healthcare system we have? His answer: we designed the system to work this way, albeit not with the intention of producing the results we have produced.
He asks, with the current system, who wins?
- The best coders win (those who know how to fill out the forms.)
- The doc who gets the most HMO patients and keeps the door shut wins.
- The doc with the lowest overhead, the fewest nurses, the smallest staff, the fewest phones, the least access, wins.
- The physician who sees the most patients per hour, wins.
- The physician who does the most procedures wins – the specialists – they get paid for the procedures. For the time they spend with patients, they get the same that I’m getting paid.
- If you’ve got a sick and difficult patient in this system, and you want to win, you refer him to a specialist, and you’re done. You saw him for two minutes, and then you sent him to someone who’s going to actually have to take care of him.
- The insurance company who can enroll the most healthy employees while minimizing payouts wins.
- The insurance company that can delay payment the longest wins.
- The insurance company that successfully excludes the sickest patients wins.
- The patient that screams the loudest and demands their care wins.This is a squeaky wheel world now. If you’ve been in the hospital in recent years you know that if you have an advocate who can walk and talk you are way better off.
- The malpractice insurers are the only consumer advocates with any power right now.
Who are the losers?, he asks.
The big losers are the patients. They pay a fortune for the care that they don’t get, they don’t have any power, and they don’t really have an option. They can just pick another person off the list of physicians who are seeing 30 people a day.
In the middle of the talk, he shows two exhibits, contrasting the difference between current practices for dealing with someone who may have pneumonia with the current system (a bureaucratic mess consisting of a 20 transaction event to get one patient through an office), and the approach that he recommends, and offers through Qliance. His approach has these parts:
- You pay a monthly fee to your doctor.
- For that, you are allowed to come to his office whenever you need to. (“It sounds crazy, but that’s how it works.”)
- They are open every day. If you are sick on an inconvenient day, they’ll still be there.
- You call them up, and they promise to see you on the day that you are sick.
- You go to the office and see the doctor. The office has testing equipment and digital xray. You don’t pay for either. They have a generic formulary and often can dispense the drugs you might need right there.
Bliss says that on the basis of their experience, 40-60% of what we spend on primary care each year is pure waste, which, he adds, shows why primary care providers today have such a hard time making a profit.
Listen to this and you will know something about the current healthcare mess that would otherwise take you weeks to uncover.