Doctor and Nurse "At Your Door" - page 2

Interesting Article on Switching Gears on the Dr. Homefront. Why can we not do something like this? Come on Entrepreneurs! Let's hear some feedback: ... Read More

  1. by   nightingale
    Thank you for allowing us to view your thoughts Ted... it helps us think too! It is almost like being in lecture class and "brainstorming' together... thank you for the dialogues opportunities....
  2. by   LoisJean
    Hey Ho! Ted and Amy: My thinking is that those docs who go solo would realize a profit PDQ. They could then afford to SUBCONTRACT nurses who are working Independently under their own business name. Interesting concept.

    Amy...why not give your boss-doc a copy of the article that started this thread...see how he responds.

    Peace and let it begin with me,

    Lois Jean
  3. by   Ted
    Originally posted by LoisJean
    Hey Ho! Ted and Amy: My thinking is that those docs who go solo would realize a profit PDQ. They could then afford to SUBCONTRACT nurses who are working Independently under their own business name. Interesting concept.

    Amy...why not give your boss-doc a copy of the article that started this thread...see how he responds.

    Peace and let it begin with me,

    Lois Jean
    I'm afraid the physician my wife works for just doesn't have the mentality to "think out of the box"! He's a brilliant man! He's also . . . How can I put this Politely?. . . CRAZY?!?!? :chuckle

    All sorts of reasonable decision choices have been laid before him in the past by many, many people. . . including hired business consultants (which he spent good $$$$ for!!!). Nope. Unfortunately he doesn't like to change.

    However. . . I can see how a model presented in the the article can possibly work for him, or any other MD for that matter!

    Cheers!

    Ted
  4. by   Dr. B Smith
    I read the article about the doctor at your door...no wait...I AM the doctor at your door. Hey, what we're doing here IS quite rare, isn't it? I just happened to find your message board while surfing the net, today; I'm glad to see so many people truly interested in taking back the field of Medicine, at least from Insurance, like we are. I think we're on to something here. We've been doing this for four long and fun years, now, and I'll tell you what -- it works! Getting rid of all that doesn't belong in between the Doctor/Nurse and our Patients, is not only "right," but it's fun, too. Medicine is a great PROFESSION, once more...at least for us, it is. If ALL healthcare workers would just "do the next right thing," now, by "doing Nancy Reagan," and "Just Say No" -- to any and all non-professional actions (whether they be coming from "professionals" who have sold us all out to big business (by joining up with Insurance Co.'s, etc.), or whether this comes from literal "Third Parties" "partnering with healthcare workers" in big business, etc.), we might be able to stop the mess that we now see going on in the medical field. For us, and for anyone who follows...you understand...there is a great big cost (to yourself) in doing this. This ain't for the faint-hearted, for sure. Saying No to Insurance and to big Hospital Administrators, all having "regulations" and "oh, you have to do this, now (i.e. filling out these tons of forms or "doing it this way because y/our Administrator says you have to...just because), before you can do "x" or "y" to/for your patients, anymore, etc., means we have to go against the grain, nowadays. At whatever cost to ourselves, shouldn't we do "medicine" the way we have been properly trained, and taught in school, anyway? Isn't that what is best for our Patients (and EVERYBODY will become a "patient," someday, won't they?), no matter what any "Third Parties" but into our lives and say? What ever happened to just doing the right thing, no matter what others say to us about it? We knwo how to do our jobs; why don't we just go and do that, once again? Are there no more real "Professionals" out there, anymore...who would never allow any "Third Party" to go and step into the middle of their (very unique and highly trained) jobs treating Patients, disrupting something as important as our work in helping those who are literally either sick or dying? Am I crazy for taking this stand, having even my fellow physicians "throw rocks" at me, in the process...because I'm now "different" by NOT TAKING INSURANCE in any form? Note: I recently talked to someone who talked to "Patch Adams," in North Carolina. You remember him; he's the one doctor who finally said "NO," and started just taking good care of his patients -- no matter what "they" said. At least you remember the movie, right? Well, he quit! He told my friend that the system got him. No one was truly willing to stop doing the things we all knew we should quit, in our present system. Imagine that! God help us all; we've literally lost our minds in the medical field of today. And I hear the politicians speeling off about how we need MORE INSURANCE -- Ha! They ARE crazy! Until we get back to the philosophy of "personal responsibility," and that includes paying for what we consume and need, we're going right down the tubes! "Something for nothing" just does not work! Just like something other than "helping patients" in the medical field, will quite predictably destroy the field of Medicine, in short time...if we all continue to allow what we're doing to proceed. It's time we all get off our tails and take the stand necessary...at whatever the personal cost to ourselves. Wrong is just plain wrong, no matter who else says "it's just the way it is," nowadays. We know what to do. Now, is anybody else out there willing to take this stand with me? Do we even care that our "Profession" has turned into just another "Business"? Think about it...

    N. Bryan Smith, MD

    ...is the originator of the original "Doctor at Your Door". His practice is located in Knoxville, TN - where Dr. Smith practices Medicine the way it used to be practiced - FOR PATIENTS. All else has been carved right out of the picture, and we most certainly do not "participate" with any immoral Insurance. (And that's ALL "Insurance," you understand.) You can join Dr. Smith, by starting your search for how to be a Professional in the healthcare field, in the light of Truth, instead of just following the pack in front of you for a change. Have your own opinion...even if it costs you something. How do you work in the Medical Field, today? Are your hands tied with stupid rules and regs., in your care of Patients. Those things you have to do are not related to actual good Patient Care, are they? Just don't do what you know is not consistent with the Profession of Good Professional Healthcare. Start discussing and studying this with your peers. The answers are there. They're just not all "easy"... We've got to change this before it's gone from our plate, entirely.
    "May the Force be with you".
  5. by   fergus51
    This is why I have to laugh when Americans think Canadians have no choices in health care. Thanks to insurance companies, American doctors and patients don't have enough control
  6. by   nightingale
    Thank you Dr. Smith for stopping by... I hope we hear from you from time to time.

    Night
  7. by   AuggieRN
    Hi: I'm new to the Board. Just wondered...if any one is doing anything similar to this Dr. and Nurse. Of course...I'm interested in doing it as a Private Practice RN. I spoke with a Home Health agency yesterday and she said often some of their referrals do not meet home bound status and would still need a Nurse to do something they can't...family won't or are able to do. Hey ....that sounds like a niche for me !! The patients would pay me privately per visit...say.....$ 35-45 depending on the service. If anyone is doing this or knows of anyone, please let me know. What kinds of services can I perform ?

    Thanks
    :kiss
  8. by   nightingale
    Well, I still get a little goose flesh when I read this article. I find it wonderful that a physician has gone to this style of practice. To have this Dr. take the time to respond here is more encouraging than words I could express.

    I went to Dr. Smith's website to see what is new and here is a page I would like to share regarding his services:

    http://www.doctoratyourdoorinc.com/service.htm


    Late Office Hours, After Hours Care - 24/7 Availability,
    MD Answers his own Phone, No Waiting in Line to be Seen and No Crowds to have to sit in before your Visit, No "System Hassles," True Privacy and Confidentiality for you at this Doctor's Office, Simplified Office Staff and Operations (so you don't get lost in the crowd of time-clocking employees, as at so many other places in Medicine), General Medical & Minor Emergency Levels of Care - all under one roof, U.S. born and trained Doctor with a Decade of ER work experience, "Family" & General Practice MD experienced in the Medical Field x twenty years, No Nurse Practitioners or Physician Assistants [because your (one) Health is worth more than that to you, and us], Medical Missions experience, Fully-Equipped Minor ER/General Practice Medical Facility - in a private setting just for you, Locally Owned & Operated - by MD himself, Pharmacy Services On Site (so we can truly be a "one stop shop" for you when you are ill), Difficult Cases Welcomed - we love a good medical challenge, Close Follow Up available - by MD, Telemedicine, Confidence and Trust in a Relationship with a Good Medical Doctor, once again.

    Dr. Smith's Old-Fashioned style of rendering Good Quality Medical Care to anyone, includes quick diagnosis and treatment of any general and/or minor emergent medical condition...right on the spot. We come to you or you come to us, now. That's right! Imagine your office or home being your "waiting room"! What comfort - and when you need it most, too, right? We can treat most anything "...from sniffles to stitches," and we do this 24 hours a day, 7 days a week. Medicine is our favorite hobby, once again; we love to treat Patients. No more busy doctor syndrome, or "can't find 'my doctor' after hours," here. And Dr. Smith has both the experience (20 years) and the training (10 years in the ER's + 14 overlapping years of Family Practice) to be able to "treat most anything that walks in that front door," rest assured. With a fully equipped office and no more Answering Service to hide this doctor from his Patients, we are just like your "old fashioned family doctor" used to be - Reliable, Accessible, Ready and Trustworthy - all for you, our valued patient. We care for you personally, and directly, just like your grandparent's doctor used to do. It's simply the best personal medical care you will find out there today. Stop by and see..."we're not your typical Doctor's Office," that's for sure!


    Emergency/Urgent Services: You can "Walk-In" to our office most any day of the week (including Saturdays) and be seen IMMEDIATELY. Because our Patients pay REAL money for their care, here, the lines are almost non-existent. Why wait for hours in the lines at the bigger Hospital ER's, or at your regular doctor's office, when you're sick or hurt? For that matter, why pay Insurance Companies all that money (every month), and get literally nothing but hassle back in return? Why go wait in a Sick Crowd before ever being Treated by the Doctor's Nurse (i.e. NP or PA), at that, too? Shouldn't you be getting anything but the ole' Bum's Rush treatment right now (which is always available for you at your Insurance Doctor's Office, or at the local Hospital Emergency Room)? I bet THEY wouldn't want to be treated that same way, themselves. With Insurance, it's all about them keeping your money; they've made billions out of the game of "not paying". Just ask yourself, "What Product does my Insurance Co. produce for me and my money?" Nice commercials? Answer: Not one thing! Why put up with the hassles within the Insurance System when you don't have to do that anymore...especially when you become either sick or hurt? Go direct! Just pay for it, yourself...and go for your own reimbursement on your own Insurance...because it's much easier and much better medical care, too. Call 865-938-8900 to be seen RIGHT NOW - 24 hours a day/7 days a week/holidays included. Then you will get to see how YOU become our first priority, every time. Now that's "Good Doctoring".

    Caretakers: Need a Good Doctor to come to the house and treat your elder family member? How about for yourself or even your younger family members? Talk about saving you both time and needed energy...we can do this for you, anytime, and we do it promptly and well. We have all the equipment and know-how ready to go for you at a moment's notice. We can be at your location within a short period of time, most often. Dr. Smith has been doing "Old-Fashioned House Calls" now for years, and you cannot beat this type of special service, in many cases. Give this House-calling Doctor a try, and see why many have come to love being treated at their own home...or office...where "your waiting room is your place," not ours. Aren't you worth this much to yourself, today?

    Parents: Isn't it amazing how waiting to have your child seen in a crowded Pediatrician's Office can make you ill? Exposure to other illnesses is enough of a reason to not do this, isn't it? Well, you don't have to do this any more! Have your child seen in private, moments after you call or stop by our office. It's that simple. We don't have CROWDS of Patients at our office for you to wade through, and we don't "treat 'em by the herd," either. We'll explain how we maintain this atmosphere just for you, when you come in, too. Your child is our only focus while you're at our place. Oh, and we also have the medications your child might need - right in our office pharmacy at our office, too. Enjoy the difference our place gives you as a busy parent! You don't need to endure "having to go to the doctor's office," anymore.

    Insurance: We accept no insurance (and all that they push onto Patients and Doctors), any longer. If we did, you would have the disaster you see at most other Doctor's offices every day, here, too. Sick and Waiting Crowds of Patients... A Doctor you can never find, who darts in and out the back door, only...and when you do "find" him/her, it's only for a few quick rushed minutes, because "your doctor" has scheduled to see this day in the office, some 80 Patients before 5pm! For Great Service at our place, you pay at the time of your visit. It makes sense; you pay when you shop at Walmart, don't you? It's simple, personal and direct - and it's just FOR YOU - the Patient. This way, we can concentrate all our efforts on you, the Patient, and not on some "Third Party" who is bent on our very destruction...so they can get rich off your premiums. We then can issue a "Detailed Bill" to you to submit to your Health Insurance Company, if you like, for your own reimbursement - "Out of Network." We do not interact with your insurance company for any reason, so please do not expect us to do this, here. We choose to "Doctor Patients," now, and not "Practice Insurance" at this facility. We've learned better than to continue this charade, in medical practice, because those that do "Insurance Medicine" are not doing it because it's the right thing to do! And, just look at their Office System of Care. Shazaam! It's horrible, and nobody likes it - Patients included. Go figure. The system of Healthcare involving "Insurance" in this country is "broke," and we need to admit this and get on with the fix...if we're going to call ourselves true "professionals," or if we want to put Patients back in First Place in the Medical Care System in this country. Doctors should just take care of Patients, from here on in, don't you think? As a Patient, you should be able to appreciate this, about us, especially. And isn't that just what "your doctor" is supposed to do, after all, anyway? Take care of (and protect) Patients, only? We encourage you to take a closer look at this issue, with your own doctor (if possible). Ask him/her why it is that they choose to take your Health Insurance, at their (and your) own destruction, anyway. It's not because it's any good for anybody, I'll tell you that right now...it's because they feel stuck! And "feeling stuck" is no reason to continue something that is WRONG - period. It's time to have some smarts, and some guts, and just do the next right thing, friends!

    ---- enjoy night

    Now couldn't WE, as Nurses, come up with Nurse Services? Anyone doing this?
  9. by   nursemicke
    WOW!!!!! What a great thread. Very inspirational, intelligent and downright logical. Thank you Dr. Smith, Lois Jean, our great moderator Nightngale and all posters.
    Anne
  10. by   Chaya
    I didn't know this couls be done. What about the legalities?
  11. by   dedjim
    Quote from hoolahan
    Only one question...what happens when you need hospitalization?

    It seems like a good idea, but it needs work. If I end up in the hospital, I want MY doctor treating me, not some hospital-assigned doc!
    Well, for me, If I end up in a hospital it is probably going to be for something very significant. If that is the case I would rather have a specialist or hospitalist conducting my care rather than a GP. No reflection on my primary provider's skills but managing a hospitalized patient is skill unto itself. I want my Primary INVOLVED in my care, and CONSULTED with by me and the specialist but she is probably not better qualified than a cardilogist, surgeon, gastrointerologist, urologist, or intensivist in caring for me at that point. I DON'T want a GP weaning me from a ventilator, generally speaking. Or managing a delicate fluid load. Or treating my 50% 2nd and 3rd degree burns. Or my ileus....etc.

    I like this idea of a pay as you go practice with a reasonable fee. It'd help bring down insurance premiums. I'd think, if everyone did that. or at least I'd just enroll for major medical and forgo the comprehensive.
  12. by   dedjim
    Quote from Chaya
    I didn't know this couls be done. What about the legalities?
    Most of the "legalities" result from taking Medicare/Medicaid money and from contractual requirements of insurance companies. Other than that the provider has a duty to abide by the professional standards of care, policed by the BoME, and the business and tax laws.
  13. by   fawnsternurse
    Hello,
    Very interesting thread. However what I am confused about is the issue of R.N.'s practicing medicine without a license. I mean, can we do this? I have done community nursing in the past and I am aware that medicare will no longer cover many services. But can i basically set up shop without working under a Physician and market myself , go into peoples homes, draw up insulin, do wound care, give baths, set up medications etc Please forgive me I am not sure that I understand how this can be done. Can anyone give any insight?
    Thank you very much in advance.It sounds like not only a great idea for us nurses but lovely for the patients as well!
    Mary Jo

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