Why I love my job!!

Why I love my job!!

Yea that's right. I love my job, because, if you have not yet noticed, I do it a wee bit different from my colleagues. You see, most of my colleagues practice what I call third-party healthcare, by contracting with HMO's or other insurers to provide your care. This keeps them very busy. A common misconception in primary care is that a busy office is a successful office and contracting with health insurers almost guarantees a busy office! Well, I have a different belief system. I believe that success in medical practice is based upon the good health and goodwill of your patient's. Do a good job, and you are a success. Do a good job meeting HMO criteria but not your patient's individual needs, and well, that is not so good!

HMO's, otherwise known as Health maintenance organizations, an oxymoron if I ever heard of one, may pay doctor's by what is called a capitated rate. This means that the HMO will pay a doctor a certain amount of $$ per month whether a patient is seen or not. This fee ranges from as little as $5/month to as much as $30/month, dependent upon your insurance plan. And by the way, the HMO insurance industry does not classify you as an individual, but as a "covered life". How icky is that??

The doctor also gets paid your copay if and when you visit the office, and occasionally an HMO bonus for meeting certain criteria. What many doctor's don't realize is that by trying to earn a bonus and meet the HMO criteria, their patient's become caught in a numbers game. For example: Did everyone get their cholesterol checked? Did everyone get a colonoscopy? No! Then call up these patient's and get it done. It doesn't matter whether the test is medically necessary, the HMO wants the test done to prove to another third-party, known as Uncle Sam, that it is providing good care. This is called population based care, and is what the present federal government wants to expand. Fit everyone into the same system, regardless of their individual history and needs. I am sorry, but this just does not work for me!! If I go to a doctor and they treat me as a number, or a statistic instead of as an individual, I am out the door quickly!

My colleagues sign 50-plus page contracts with insurers that they do not read. These unread contracts allow third parties power over your healthcare. Seems a little like the 2000+ page Congressional healthcare reform package that is alleged to be able to improve patient care. The only thing that 2000 page bill will cause is a hernia trying to lift it! And if you ever had a hernia, it hurts!! A 2000 page bill certainly will not improve patient care. But let me not digress. These insurance contracts allow the insurer to set up medical guidelines for your care, such as what type of tests to order, and what medications are covered. In essence they take the doctor and make him or her a robot. Now there are excellent doctor's who work within the system. In fact, I believe that 99% of doctors are highly skilled, competent and can do an excellent job. But if they put themselves in a system that restrains them from providing proper care, well, that is not a system that I care to be a part of!

I strongly believe in preventive care. It was one of the major factors in the founding of The Institute For Medical Wellness. But no two individuals are alike. Healthcare needs to be individualized to the patient's needs based on their personal and family health history. I do not allow any third party to tell me what to do for my patient's. If a doctor signs a contract with an insurer, that insurer is inside his head during every patient encounter. Not my idea of individualized patient-centered care.

So why do I love my job? The answer is fairly simple. I have designed a practice that caters to the individual, without any third party intrusions. I offer yearly wellness-retainer options, or payment at time of service for those that do not want a retainer. The retainer options can be paid all upfront, or with a down payment and monthly checking account debit. This monthly checking account debit is essentially a capitation for my services. But my services are spelled out in a simple easy to read and understand two-page contract between myself and my patient. There are no hidden clauses, no ulterior motives and no third party in my exam rooms. I am capitated, but to my patients, and not to any third party.

I average 10-15 patient visits a day, instead of 25+ when I went by the name of "insurance healthcare provider", which is actually pretty funny. When I was a kid, and people asked what I wanted to be when I grew up, I didn't say, "I want to be an insurance healthcare provider." I think, no, I am positive, I said I wanted to be a doctor!

And so I am, and I love my job!!

Now take a poll of other doctor's. Ask them if they love their job. You may be surprised at their response.
-------------------------------------------------------------------
Healthcare Reform and the AMA

Yes, another healthcare reform piece. We hear all the time on the news how the AMA, (American Medical Association) supports the present healthcare reforms in Congress. As a doctor, I must ask myself why? My job is to do the best I can for my patient's. That is the oath I took when I graduated medical school. The AMA has no such oath. The AMA, by supporting the present reform bills, is watching out only for their corporate entity. I encourage you to read a short piece about why the AMA has thrown doctors and patients under the bus, in favor a huge income windfall from the government. You will be very surprised to find out who the AMA represents and where they get their revenues. I'll give you a hint. The first name in Uncle and the second name is Sam.

To Good Health !!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

H1N1 Revisited

H1N1 revisited

The H1N1 vaccine is now becoming available in many schools and community health centers. Whether to get yourself or your child immunized is a decision that has caused much angst. As I have stated in past newsletters, I have strongly supported the use of the yearly seasonal flu vaccine. But I had not, as yet, supported the use of the new H1N1 vaccine. I feel that building up your bodies immunity thorugh a healthy diet and lifestyle, along with an increase in Vitamin D is the best and safest way to prevent influenza. Please look at the following excerpt from the Vitamin D council website on Vitamin D and flu.

http://www.vitamindcouncil.org/newsletter/vitamin-d-and-h1n1-swine-flu.shtml .

New information has been gathered about the production and manufacturing of the H1N1 vaccine that has lowered my fears about this new vaccine.

So I am now led to believe that the H1N1 vaccine is another option in prevention of H1N1.

Why the change of heart?

A few of my earlier objections to the H1N1 vaccine were:
-the presumed quickened production cycle of vaccine production
-the possibility of untested and potentially unsafe adjuvants (additives that help provoke a stronger immune response)
-newer untested manufacturing processes
-low rate of hospitalizations and death did not warrant a new vaccine
-being a "testee" for a new vaccine


Let me explain how these concerns have decreased.

I viewed a letter from Margaret A. Hamburg, M.D., Commissioner of FDA which can be read in its entirety here. This letter calmed many of my objections about the H1N1 vaccine. It stated that the manufacturing process and production cycle of the H1N1 vaccine was followed almost identically to the production of the yearly seasonal flu vaccine. No new adjuvants or untested additives were used in the production. The hospitalization and death rate have not been higher in H1N1 influenza, but this virus strain appears to be more contagious than most. So as a percentage of the population infected, it does not appear more deadly. But as so many more people have become ill with H1N1 than with seasonal flu, there have been many hospitalizations and deaths. More worrisome is that the H1N1 flu is most dangerous to healthy children, due to their strong immune response. It appears that some children's immune response go into overdrive, which results in more hospitalizations and deaths. As with other flu's, it is also dangerous to individuals with weak immune systems, chronic medical conditions such as asthma, cancer or heart disease, and pregnant women. So as I recommend the seasonal flu vaccine each year, I no longer see a reason to oppose the H1N1 vaccine.

But as immunizations are a personal health matter, it is still up to each individual to decide for themselves if they want the vaccine. My office will not be ordering the H1N1 vaccine, as there will be many places in the community offering the vaccine in the future. To find a location please click here. At present, if you choose to get the vaccine, I would stick to the injectable version as I am not convinced that the nasal mist has enough data behind it to be pronounced safe or effective.

Again, whether to receive the H1N1 vaccine is up to each individual's philosophy on health, and I will support whatever decision you choose!

To Good Health !!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311