The Only Constant in Life is Change

Healthcare is changing.  When we started Personal Healthcare Providers in February 2004, the world was a different place.  For example, prescribing medications was easy.  I called a pharmacist personally, and they filled a prescription in a timely fashion.  Now the process is impersonal and complex.  Likewise, ordering labs was simple.  We sent orders to one of a couple labs, blood was drawn by a technician, and I received all results prior to your appointment.  Now, the process is complicated, and I rarely get all the information I requested.  Even admitting patients to the hospital was straightforward.  Now it is a nightmare as hospitals are packed full of sick people and new hospital policies dictate what I can and cannot do on your behalf.  Everything, it seems, has changed for the worse.  And this was pre-Covid.  The pandemic has only stressed our healthcare system further and exposed its fragility.  In reality, we don’t even have a healthcare system anymore.  We have a $4 trillion sickcare industry.  An industry that generates revenue off sick people.  It wasn’t designed this way; it is simply how the industry evolved.  Whatever the reason, this industry certainly does not value your health.  

Health, of course, is the very domain of primary care and the reason I started Personal Healthcare Providers nearly 18 years ago.  Health is not the absence of disease; it is the ability to avert disease in the setting of environmental stressors.  And the stressors are increasing.  Many of you know, in addition to practicing medicine, I have spent the past 5 years studying the science of health and disease.  This has led me to discover an emerging field called Systems Medicine which I believe has the potential to transform our healthcare industry.  While conventional science has led to significant advances over the past 100 years, it is insufficient to help us deal with the current and future burden of chronic disease.  Systems Medicine takes a different approach.  It looks at you as a complex biological system with a unique combination of genetic variants and environmental exposures.  It also looks at you as a member of your local community, which is itself a member of a larger complex biotechnological ecosystem.  It is harnessing the power of Artificial Intelligence to create computer models of you as a whole person which will enhance our ability to prevent disease.  I am currently collaborating with systems biologists and systems engineers in developing this field, including those from the Johns Hopkins Applied Physics Lab.  Also, I recently joined my colleagues on a NASA grant proposal to model data from the International Space Station looking for early indicators of disease processes.  Ultimately, modeling diseases as complex, nonlinear processes will allow us to detect and mitigate problems before they actually cause dis-ease.

In order to take advantage of the clinical opportunities System Medicine has to offer, I will be making some changes to our practice.  Among the changes is the implementation of an Electronic Medical Record System (EMR).  We are currently vetting several systems and hope to implement one by the beginning of next year.  It is simply no longer possible to run a primary care practice manually.  Also, as most of you know by now, I hired a nurse practitioner, Erin Prokop.  Erin received her Bachelor of Science in Nursing from Johns Hopkins University and her Master of Science from the University of Maryland.  She is certified as a Family Nurse Practitioner and has twenty years’ experience in conventional medicine.  Erin is also certified in a growing field called Functional Medicine and, like me, is a systems thinker.  Erin has proven herself to be an incredibly capable and compassionate medical provider.  She is also the first concierge Nurse Practitioner I know of in the area.  Erin and I will work together to improve the delivery of primary care services to you next year.  We will also be adding several new medical consult services to help patients reverse complex disease processes.  Finally, there will be some changes to our fee structure to support these enhanced services.  For most patients there will be a nominal increase in the annual fee.  Also, insurance companies are now reimbursing for services not previously covered – such as telemedicine, review of medical records and physician-to-physician communication.  We will continue to bill for all services covered by insurance companies, but we will also submit a claim to get these services reimbursed on your behalf.  

Yes, healthcare is changing.  But I believe for the better.  In 2004 we were the first concierge model in the area.  Now it is commonplace.  In 2022 we will embrace Systems Medicine.  I believe in 2040 it will be commonplace as well. 

If you want to read more about our practice and philosophy of care, please visit our website here.  

Yours In Health,


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