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Pay As You Go Medicine

Today patients are looking for a personalized healthcare experience. The expectation is met with a completely opposing paradigm of mandated, protocol-driven “health”care. Instead of the headbutting, alienation, and scorning of parties, there should be a resolution to incorporate some “best practices” while giving a personalized experience. And I must clarify that an “experience” implies that there is one episode of care, and perhaps we should use the term “approach” when we talk about someone’s healthspan. The healthspan is that time you are alive living in good health. This healthspan and how you define yours may be crucial in how you spend your health care dollars. Let your healthspan determine your health plan.

When one signs up for a health insurance plan, there is a list of paid procedures, visits, or labs that the actuarial data miners endorse, because those tests (i.e., preventive visits, labs, mammograms, colonoscopies) can prevent future healthcare dollars spent in the population. Of course, we medical personnel subscribe to finding a problem early so it does not become a big problem down the road. We have taken an oath to do what is best for you. However, the insurance industry is exactly that, an insurance industry. There are other things medical providers think may be of benefit to your healthspan, but you may not ever get to dive into those deeper topics. Those topics are the underpinnings of what have made you ill or suboptimal in the first place. Fatigue, low hormones, poor energy levels, toxic exposures, inflammatory eating, polypharmacy, psychosocial troubles, and poor sleeping are some of those problems lying within your matrix and biofield. That is hard to capture with data points and check boxes. Plus, you may only have access to those bare minimum check boxes deemed as quality metrices. You get those things on the checklist done, but you may not feel any better and want to investigate your problems further. An insurer may see no value since the data is hard to tap into and quantify. If it is hard to quantify it may be difficult to assign a benefit to it.

This is where (as I call it) “Pay as You Go” medicine has taken functional and individualized health to the forefront. Its cousin, “Concierge Medicine,” goes after a monthly payment system to have (sometimes) unlimited access to a physician who knows you and can take care of many issues well because you are a member and can be seen readily. Not all concierge practices are functional and integrative, but they certainly fill a niche when traditional practices are overwhelmed with the current insurance, employer, and government structures in place.

“Pay as You Go” medicine lets you as the patient be at the helm every step along the way. The patient pays for whatever health topic is discussed and whenever that patient has a need, because it is your personalized physician waiting to address your acute or chronic health concern. Access is great. Many of these platforms are virtual for the provider’s ease of delivering health care and advice while the patient is “on the go.” These offices tender cash up front, but also thinking through a patient experience, the patient needs not be insured to do this. The patient can use discretionary income, much like going to the gym, buying supplements, going to the chiropractor or therapist, and other cash-based healing enterprises. The virtual offices and the robust cloud-based electronic health records make it amazingly quick and simple to schedule acute and chronic visits, obtain supplements or prescriptions, and gain access to more advanced lab testing than what traditional practices can do. Insurance-driven health systems get mired down in the authorization process and medical “justification” to prove to an insurance company that a test is worthy of payment. If a patient chooses to pay as he goes, some of those expensive tests can be foregone for a more healing approach to optimize the body’s capabilities of repair once the trigger or root cause is figured out. There are many pieces to the healing wheel, and for sure, medications, surgeries, and emergency services are appropriate for the right time.

The patient drives the ship and either endorses or vetoes the next steps in visits, testing, and treatment. Diagnoses may have several paths to wellness, but if a patient is taking a harmful path, I will steer them off that path. Education is a large part of the “Pay as You Go” model so that you are given tools to help move your healing journey forward. This journey is quite unique in that you may need completely different work than someone else with your condition. You may have spiritual, mind/body issues to take care of while the next person has a toxicity to remove. Others may have biochemical and nutritional needs, while others are lacking proper movement or sleep. The combination of issues is endless and is what makes each patient different and the practice of medicine exciting. We live in an ever-evolving world of scientific advances, and functional medicine is where you will find it clinically.

Welcome to my “Pay as You Go” virtual office where I will meet you where you are. Then I will walk with you from there.

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