Have you ever wondered what happened to the good old days of medicine? We’ve all heard patients lament the loss of the Marcus Welby experience.
Who? He was a doctor on TV a long time ago. But he was a great guy, really friendly. He made house calls and everything seemed so much more personal. I have an article from a physician, I really admire, that captures the heart of the matter better than anything I’ve seen in a long time. He’s not available to interview, by me at least, and I wanted to share it with you in this podcast.
Hello! Welcome to the Cash Practice Solution podcast. I’m your host, Doctor J. This week we’re talking about the sacred trust of the doctor patient relationship.
Doctor Joseph Varon, is the president of the Independent Medical Alliance at IMAHealth.org which you should look at because they’ve got some amazing stuff. He’s also a critical care specialist in Houston, and this is what he wrote in his article.
“When I was a young medical student, I believed with all my heart that medicine was the highest calling a human being could answer. We were not just training to earn a degree or secure a physician. We were stepping into a lineage, inheriting a tradition that stretched back to Hippocrates, Galen, Vesalius, Sir William Osler, and countless others who saw the care of the sick as a sacred covenant.
Every time I walked into a ward, I felt nervous and exhilarated. It’s as if I was entering a cathedral where the human body and spirit were laid bare.”
Wow. Poetic.
A Patient’s Trust is not a transaction.
He’s obviously a very, very spiritual guy and really feels this, and I know that feeling. I’ve never had the feeling like I was in a cathedral when I was in a patient room but, I do remember when I was a medical student and I was at my first delivery, the first time I’d seen a baby born. And I wasn’t in control of my emotions, I just wept. It was hard to control myself because it was unbelievably spiritual and sacred and beautiful and overwhelming.
Those kinds of experiences, they’re unique to doctors lives. We get to be with people in the most incredibly wonderful moments and the most horrible, frightening moments. And we get to be there. Because we’re doctors. This article that he wrote is much longer than what I’m going to share with you. But the parts that I am sharing are the parts that really struck me. He goes on, “A patient’s trust was not a transaction. It was a gift, a profound act of vulnerability to be allowed into that sacred space was to be given a responsibility greater than anything I’d known.
We didn’t speak in a language of compliance metrics or quality indicators. We spoke of healing, of service, of devotion. Medicine wasn’t a career. It was a vocation, a purpose, a life anchored in something deeper than self.”
When’s the last time you heard that? That’s been a long time for me. This article really it summed up so much of what I have really lived.
My medical life is for really healing, service, devotion. But man, it is not necessarily embraced. And he says in this, “it’s a vocation, a purpose, a life anchor in something deeper.” That vocation is that you have, it’s not a job that you look forward to and you interview for, and you do your medical school and you go get a job.
It’s a calling. It’s deep within you. It’s in your heart. I finished my medical training, and, I went and taught at the medical school, in Fort Worth and in Corpus Christi and for the medical school in Corpus Christi we started a Home call service because people needed it. It wasn’t something that was, reimbursed very well. I think it was $30 or $35 to do a house call. It is a lot of work, a lot of time, a lot of effort. People were really sick. It wasn’t easy, but it was awesome. I had a lady in a home where she was, she was by herself, and she was somewhat buried in blankets. She had, caregivers who come, for a couple of hours a day, but she had probably 6 or 7 blankets on her in the corner of a house, and she’d get Meals on Wheels. She was basically lonely, and she didn’t really have the means to get to the hospital or a doctor’s office, and I’d make house calls on her. We were friends. I’d cut her toenails for her. I’d take care of her heart medicine. And that’s all I got out of it. And I enjoyed it. It was really fun. It didn’t work out necessarily the way that you would expect an altruistic, loving gesture to work out. I’ll tell you more about it in a minute,
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In the article, Varon goes on.
“As the years passed, the culture of medical education further eroded vocation, student centered with idealism, but were buried under debt, exhaustion and cynicism, long hours and relentless pressure. It might have been tolerable if you had real mentors, but too often residents were taught that obedience mattered more than judgment, compliance more than conscience. Independent thought was punished. Curiosity was suffocated.
By the time many young doctors finished training, the fire that brought them to medicine had been extinguished. They learned to survive, not to serve. They asked, how do I get through my shift? Not how do I heal the patient? So vocation faded into memory.”
Wow. Bummer. Osteopathic training was different than that for me. I didn’t have that same problem. I went and trained in a tiny hospital with 60 beds, and we had mentors. We had doctors who worked there who were in very small practice situations, and they had time. And, because I’m an osteopathic physician, I was trained in osteopathic manipulative treatment, which is not part of the regular practice of M.D. medicine, but excellent.
And I really connection with patients and creative solutions were really embraced. Part of that was osteopathic treatment. Back to the House Call Medicare thing. When I did the House call service, that’s where I really experienced the crushing of invention or compassion or the things that really make being a doctor a calling and not just a job. I did house calls under Medicare for about a year, and Medicare decided doctors don’t do house calls.
They thought, It’s got to be fraud. So they launched a fraud investigation to make sure I really did it. I showed them all my records. I really did it. And they basically left me alone after some threatening language. I took care of the problem, but Medicare basically drove me out of that area of medicine because I didn’t want to have to deal with that kind of punitive behavior.
But I have good news for you. All of what he’s saying, all of what I’m sharing, cash practice is the escape hatch. It’s how you can actually provide the care the patient needs in the way that you desire, in a way that’s acceptable to the patient because they’re willing to pay you for it. And you can actually make a difference.
You can get back to that person who you’re responding to in your calling. If the patient chooses be cared for by you, you can choose to give them everything that you have, every bit of interest you have, for every bit of information you have. If you need to spend time to research, you can. If you need to charge for it, you can.
If you decide to give it away, you can.
I’ve done all those things.
Cash practice has the potential to turn the tide of everything Varon is talking about.
Everything he’s talking about, all of that abuse, all of that disillusionment, all of the loss of calling. It sounds like it’s crazy, but the grassroots movement of cash practice has the potential to change it.
Everything else top down the government. I think we’ve seen for the last 50 years, it’s not going to happen. The government is not going to do it. Insurance companies are sure not going to do it. We have to do it. And Varon at the end of the article says this: “if we succeed, perhaps one day a new generation will walk into a hospital with the same awe I once felt, where they’re part of something sacred, where that medicine isn’t a commodity, but a covenant.
That is the vocation of medicine. It’s the beating heart of our profession it’s worth fighting for with everything we have left.” Yes. Oh that’s great. He’s right.
And I believe the access point is cash practice. Everything else, you’re working for the man. You have to follow the guidelines. You have to fit within their parameters. The way that they decide that it needs to be done, regardless of what the patient needs in that specific situation.
You will see it one way, they see another, you have to follow the rules, or it’s fraud or some kind of violation of a contract or something. And then you’re stuck. So I say cash practice is the solution. That’s why we call this the cash practice solution.
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It’s the ultimate operating system for a successful cash practice. If you’re ready to take your practice to the next level of joy and real success. I’m talking about the sacred trust. Financially less hassles, going to bed at the right time of night, no pajama time getting your records done. Check us out at EspreHealth.com. Thanks for tuning in to the Cash Practice Solution podcast.
I’m Doctor J. I’m here to remind you, a fulfilling cash practice is within your reach. We can help you get there. If you want to optimize your current cash practice or start a new cash practice out on the right foot, we’ve done a lot of them. Check out all of our resources at EspreHealth.com.
So until next time, listen to your patients, learn their stories and love them with all your heart. You will be unstoppable.
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We’ll reconnect in the next episode with more ways to help you succeed.
