Given that close to 50 million Americans already lack health insurance and more are losing their health benefits along with their jobs, rest assured that whoever wins the election in November, healthcare reform will be a high priority.
But the changes that would truly improve our nation’s health won’t come from political fixes that merely prop up flawed systems—systems that enshroud patient care in adminstrative hassles, that frustrate physicians, preferentially reward expensive disease care interventions, provide little support for prevention, and all too often disappoint the patients they allegedly serve.
Real reform is already starting, at the grass roots level. You find it in the clinics of doctors who’ve reclaimed their noble calling as healers, and who’ve found ways to serve their communities with the kind of care that kindles peoples’ innate, though often sputtering desire to be healthy. It is emerging from new business models for prevention-centered care, new integrative care systems that allow practitioners of diverse disciplines to work together for the good of their patients.
To help further this movement, Holistic Primary Care is proud to announce our first conference, Heal Thy Practice: Transforming Primary Care, an intensive program focused on business development and practice management strategies that can empower you to develop a thriving holistic primary care practice.
The first conference of its kind, Heal Thy Practice will highlight a wide range of practice models, including straight fee-for-service, concierge care, holistic medicine in the insurance context, corporate wellness, medical spas, new models of eldercare, and others. Attendees will learn from doctors who are successfully practicing in these diverse settings.
Heal Thy Practice will be held at the Westin La Paloma in Tucson, Oct. 31–Nov. 2, and chaired by Grace Keenan, MD, medical director of NOVA Medical Group, a 4-site comprehensive integrative care group in the Washington, DC, area. NOVA offers everything from urgent care to spa services, and employs a broad spectrum of healers including allopathic primary care doctors, naturopaths, nurses, acupuncturists, nutritionists, exercise trainers, and massage therapists.
A Model of Colaborative Care
Over the last 20 years, NOVA has quietly emerged as a national model for holistic, collaborative care as well as a testament to physician-driven innovation. It also happens to be the largest primary care practice in Loudoun County, VA. But Dr. Keenan, an internist, says she never set out to redefine the business of medicine. “I just wanted to be a good doctor and serve my patients well, and I found that was really hard to do in the existing healthcare systems.”
Nor did she start out as a big believer in holistic approaches. Early on, she was rather skeptical, but quickly realized that drugs and surgery, the mainstay allopathic tools, fell short of many patients’ needs. Personal health issues forced her to take time off, during which she read up on “alternative” modalities. Her mind opened, and her approach to practice soon followed.
“The conventional medical box has very rigid edges that do not correspond to reality. Hard stances do not work. Learn to be open. Learn about what is helping people. You learn this by listening.”
Around a strong nucleus of primary and urgent care, NOVA soon grew to include acupuncture, nutrition, stress management, and many other services, part of Dr. Keenan’s desire to give patients a one-stop health center. NOVA even has a gym, so people can actually implement the exercise plans their doctors and fitness counselors recommend.
The latest addition to the NOVA-verse is a medical spa, opened nearly 3 years ago and offering a range of massage therapy and personal care services. The spa provides a strong fee-for-service and retail revenue stream that offsets the time- and cost-intensive integrative medical services, while augmenting the medical therapies and amplifying NOVA’s self-care and wellness message.
Engendering creative and respectful relationships between practitioners is a key to NOVA’s success. “Patients want us all talking together. They do not care about our interdisciplinary turf issues.” To this end, NOVA holds periodic case reviews where healers from different disciplines sit together to study interesting or instructive cases, and to learn from each other.
“You can’t be elitist with regard to other health professionals. All of them bring something to the table, and all should be treated with equanimity and respect.” This holds true for non-practitioner staff as well. Often, it is front office staffers who have the best handle on what’s going on with patients, and what’s happening in the community at large.
New business often comes from old relationships, so cultivating relationships in one’s community is essential for practice-building. Dr. Keenan said NOVA’s new corporate wellness programs emerged from relationships she already had through her work as an occupational healthcare provider for companies in Northern Virginia area.
First and foremost, though, is the relationship with patients. “Always strive to meet their needs while exceeding their expectations.” This takes a balance of confidence and humility: confidence in your knowledge and clinical skill, and the humility to recognize when others are better able to help your patients.
“I’ve never had anyone criticize me for recommending them to an acupuncturist or an ND, or a nutritionist or a massage therapist,” said Dr. Keenan. “On the contrary, people feel that I really care about them if I refer them to someone who is more qualified to help them than I am.”
Dr. Keenan built NOVA on her own, without outside financial backers. She believes many other physicians have the potential to transform their practices. It requires good business skills, which one can learn (Hey, you got through med school, right?), combined with clear vision. At Heal Thy Practice, Dr. Keenan will share the practical skills and strategies she’s gathered over the years.
“You have to start with, Why are you doing what you’re doing? Have you really thought that through? Our mission at NOVA is clear: To help people live happier, healthier, more meaningful lives. Everything that happens in the practice, from the choices of therapies to the design of the reception area is aligned with that.”
Diverse Approaches; Common Goals
Among the other featured speakers at the conference will be Brian Forrest, MD, a family physician in Apex, NC, who radically transformed his practice after realizing that, like other primary care doctors in his county, it cost him roughly $50 in overhead for every $39 he earned via insurance reimbursement.
The success of his fee-for-service model, which lowers costs to patients, enables him to break even after the first 4 visits of the day, and permits him to spend 50 minutes of every hour with patients, has made Dr. Forrest a highly sought speaker in family medicine circles. At Heal Thy Practice, he will share strategies for transitioning to fee-for-service, cutting overhead, and optimizing patient care.
Dickson Thom, DDS, ND, clinical professor at National College of Naturopathic Medicine, Portland, OR, and a leading practice management consultant for holistic, naturopathic and integrative physicians, will describe how to apply the principles of holistic medicine to “diagnose” and “treat” your practice.
Dr. Thom’s “Health of Business and the Business of Health” seminars are based on the idea that a medical practice is a living system, an “organism,” that may be healthy and thriving or diseased and dysfunctional. By evaluating the flow of energy, attention, currency and resources in your practice, you can identify excesses, deficiencies and imbalances, and develop a “treatment plan” to restore homeostasis, health and vitality to your practice.
Elson Haas, MD, founder of the Preventive Medicine Center of Marin, shares more than 30 years’ experience practicing holistic medicine both outside and within the constraints of insurance (for a feature on Dr. Haas, visit www.holisticprimarycare.net and read Defining Your Values is Key to Building a Healthy Practice). Janice Gronvold, a healthcare marketing consultant and medical spa expert will identify opportunities for physicians at the convergence point of the spa, hospitality and senior-care industries. Alan Dumoff, JD, will review new developments in the medicolegal aspects of holistic medicine. More speakers, guest keynotes, and sponsored breakout workshops will be added in the coming weeks.
“It is with great pleasure that I chair this conference,” said Dr. Keenan. “For healthcare practitioners to succeed in providing good care while maintaining a healthy life-balance, we require new models. Heal Thy Practice will explore a variety of strategies to achieve these goals in a collegial atmosphere of empowerment, at one of the Southwest’s loveliest resorts.”
For more information on Heal Thy Practice: Transforming Primary Care, and to register for the conference, visit www.holisticprimarycare.net and click the green “Heal Thy Practice” button.
