8A | SATURDAY, JULY 21, 2018 | SIUSLAW NEWS
“If the care I’m providing is go-
ing down, then maybe I have to
She continued, “Did you trip?
see less than 250 people,” she said.
Are you heavy? Do we need to
While these clinics do provide
work on weight loss?”
a better quality of care, they are
And the visits are not limited.
not intended to be the sole medi-
Patients can see Gitnes as many
cal facility for their patients. They
times as they need.
still do not cover actual lab work,
“I don’t flatter myself to think
surgeries or specialists, though
people really want to spend a
they are looking into expanding
large amount of time with me in
their offerings.
my office, unless they have a re-
Again, patients to these clinics
ally good reason to be there,” Dr.
still need to hold onto their insur-
John Egar joked.
ance.
Egar is the owner of the newly
“We don’t encourage anybody
formed Siuslaw
to change their
Medical Clinic,
“Every provider wants to have more time with their insurance,” Dou-
another
con-
da said. “We had
patients and have a better relationship. But it’s frus-
cierge clinic in
one
business
trating because they have to do what they’re being who signed up
the area, which
follows a simi- told to do. ... A lot of the providers, myself included, five people and
lar format. As of just said ‘enough.’ We can still provide care, but we can say, ‘Maybe we
right now, he is do it differently.”
should go back
— Melinda Gitnes, Northwest Reflections to this.’ We told
the sole doctor
at the clinic, but
them to wait.
he’s looking to
The problem is,
bring on others.
what they went into medicine for. insurance is built for big, cata-
The long-time local physician They’re not coming into the pro- strophic events more than it is for
was inspired by Gitnes’ use of the fession to fill out paperwork.”
everyday living.”
model after becoming frustrated
And then there’s dealing with
Beyond emergency needs, in-
with the experiences he had as a insurance companies.
surance will still be needed to
physician in the medical system.
“When I worked in Springfield, cover the costs of medications,
“You don’t really have time to there was a group of physicians blood work and referrals to spe-
see a patient,” he explained. “And who just said, ‘That’s it, we’re cialists.
then there’s the amount of red done,’” said Gitnes. “The insur-
While concierge is a supple-
tape you have to go through to ance companies were dictating ment to insurance and not a
even get the prior authorization to the clinics who you would see, replacement, Douda has found
for each and every visit, each and how many you would see and some in the community who just
every test, each and every refer- what you would see them for. You don’t have access to health insur-
ral.”
were spending your whole time ance at all.
By getting rid of the red tape of filling out documentation and
“In my mind, I thought we
insurance and overhead, Egar and submitting them to the insurance would have a particular popula-
Gitnes believe that they can give companies. And then they would tion of Florence that’s going to use
patients something that many in kick it back to you, saying you us because they have the money,”
the region feel they lack: access.
didn’t put something in the right she said. “Then we realized there’s
“Say you moved into Florence section.”
a majority of people in Florence
and you’re now on the waiting
The publication The Hill re- that are living and working in
list for a primary care doctor,” ported in August 2017 that 24 a town they can hardly afford,
Egar said. “Maybe waiting in the percent of patients were denied and so they aren’t insured. That’s
walk-in clinic for one prescrip- medical treatment by insurance something that slapped me in the
tion isn’t good enough for you. companies. In 70 percent of those face.”
Or maybe you need responsive- cases, the denied treatment was
She spoke of one business own-
ness right away, and a phone tree for an illness or condition de- er who couldn’t afford health in-
in a different state won’t help you. scribed as “serious.”
surance for themselves and were
I would be able to provide these
Most consumers reported wait- relying solely on the emergency
things the same day, with all the ing more than a month to even room for care.
services that we normally provide hear whether their claim was
“We’re at least affordable,” Dou-
in a primary healthcare clinic like denied, the report said. And 29 da said. “It’s enough so they can
at PeaceHealth. And having the percent said their condition wors- start getting care.”
security may be worth it for those ened while they waited for a de-
Gitnes and Douda hope that
who could afford to pay it.”
cision. Thirty-four percent had to the majority of people do get
The clinics are not intended put off or forgo treatment entirely proper insurance, using their
to be a complete replacement for because their insurance provider clinic as a way to gain better ac-
hospitals, and patients are still refused to pay for it.
cess to healthcare. But better ac-
strongly encouraged to keep their
All told, the report stated an cess has raised issues about the
health insurance.
estimated $471 billion was spent fundamental fairness of concierge
“We’re not everybody’s pri- annually just on billing and in- medicine.
mary care,” Douda said. “A lot of surance-related administrative
Does paying separately for
our patients have primary care costs alone, regardless of the final an off ramp from the long wait
through PeaceHealth.”
outcome.
lines and short visits of tradition-
Gitnes added, “It’s nothing
“It’s just become such a night- al medicine create a disparity in
against PeaceHealth. It’s a num- mare for the medical side to pro- who receives the best medical
bers game. There’s so many pa- vide the type of healthcare they services?
tients here, and there’s only so want to provide,” Gitnes said.
“A lot of people are here on
many providers. They are trying “Every provider wants to have fixed incomes,” Egar said. “They
to get through all the patients, but more time with their patients and expect their Medicare to suffice.
there’s not enough providers.”
have a better relationship. But it’s For us to say, ‘No, we’re going to
Attracting and retaining clini- frustrating because they have to charge you extra for being a pa-
cians has always been a difficult do what they’re being told to do.
task in a small, rural community That’s how it is in most places.
like Florence, which is constantly A lot of the providers, myself in-
in competition with larger cities cluded, just said ‘enough.’ We can
with higher pay and more ame- still provide care, but we can do it
nities. This tends to create longer differently.”
wait times for doctors to see a pa-
Gitnes and Egar see concierge
tient.
health as a way to help counteract
But the entire healthcare sys- these issues. By not having to deal
tem, and how clinician/patient with insurance companies direct-
relations are organized, also con- ly, they are able to give direct care
tributes to wait times. And it’s in a timelier manner and save
those trends that Egar and Gitnes costs by not having to hire addi-
are trying to buck.
tional staff to just to work with
“At a clinic I worked at in insurance.
Springfield, on my first day they
Because the overhead is small-
said my first roster was 3,000 pa- er, and the paperwork is less, they
tients,” Gitnes said. “I thought, are able to spend more time with
‘My gosh, how am I going to get patients, and limit the number of
to know my people?’ You don’t. patients they see in a year.
You have patients every 15 min-
“I will limit my patients to 300
utes, five days a week. You come so that I will guarantee the pa-
in, you have one ailment that tients the care they expect,” Egar
you’re allowed to treat. Someone said. “If I have time on my hands
had diabetes and hypertension, and I’m twiddling my thumbs, I
you don’t get to treat both. You may take on more patients, but
get to pick one. What kind of care by and large I will be happy with
is that?”
those 300 patients.”
The reasons for the 15-minute
Gitnes is topping her panel at
wait time are many.
250 patients per year.
CLINICS from page 1A
A September 2016 article by
Forbes found that for every one
hour a physician sees a patient,
they are required to spend two
hours on paperwork. There are
multiple forms from administra-
tion officials and lawyers seeking
information, beyond the typical
paperwork that is needed to keep
track of patient care. The study
found that only 27 percent of a
physician’s time is actually spent
face to face with a patient.
“The providers are getting very
fed up,” Douda said. “This is not
tient at this clinic, and if you’re
not a member, then you don’t
get in,’ that feels unfair to them.
And it is. The system of payment
that I’m operating is not fair, and
it grieves me. I will try and reas-
sess in the future, but for now, it’s
a simple set price a month for all
comers.”
Neither of the clinics believe
the concierge clinics are the an-
swer to all the problems with
healthcare.
“I think the funding model in
this country with all the com-
plexities and regulations is just
a patchwork of Band-Aids that
doesn’t deserve to hang around,”
Egar said. “I think both people on
both sides of the aisle would say
it’s broken. You have to start and
imagine what’s the best and most
efficient situation, and then plan
your solution from there.”
What that solution could be is
anybody’s guess.
“If I had the answer to fix
healthcare, I would be a bizzil-
ionaire and have the Nobel Peace
Prize,” Gitnes said. “I try and keep
it simple because I’m a bit of a
simpleton. I don’t know how to
change the world, but I know how
to change the world I live in.”
For more information on Siu-
slaw Medical Clinic, 1845 High-
way 126, visit siuslawmedical.
com or call 541-999-6599. For
more information on Northwest
Reflections, 5292 Harvard Ave.,
visit nwrhealthandwellness.com
or call 541-590-3906.
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