This Dr. has it right!

Nurses Activism

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  • by SDALPN
    Specializes in Peds(PICU, NICU float), PDN, ICU.

http://www.wral.com/news/local/story/8805878/

Watch the video. He was on the local news today. He should be hiring nurses instead of medical assistants...but other than that I can't complain. This is how healthcare should be!

https://forrestdirectpay.com/blogs/brian-forrest

Apex, N.C. — A medical practice in Apex does what few in America do: It doesn't accept payment through health insurance coverage.

Dr. Brian Forrest opened Access Healthcare in 2002 to make health care more affordable for people without insurance.

The practice displays fees for individual services – $49 for a physical and $30 for a cholesterol test, for example – in the waiting room. Patients pay upfront for the various services in what is called the "direct pay model."

"We don't file or accept insurance of any type," Forrest said recently, noting that eliminating the paperwork involved with insurance claims saves his practice about $250,000 a year.

"If you were to go to a traditional office, you see someone who's filing insurance, somebody who's doing the billing, somebody who's doing the coding," he said.

Access Healthcare's staff includes only a receptionist, a medical assistant and a nurse practitioner in addition to Forrest and another physician.

tralalaRN

168 Posts

Specializes in pediatrics.

I had seen this earlier tonight also, and was very impressed by this Dr's practice. No nonsense - how simple it should be to receive medical care. Not all this hoop-jumping!

On an aside - my daughter was visiting in France recently and became ill with what we thought was probably a sinus infection. She was resisting going in to be seen/treated, as she thought that without being a citizen, being out of the country and dealing with insurance in a foreign country, that she would end up paying so much. Well, she finally broke down and went in. The entire visit - to diagnose *and* tx w/ antibiotics - $60 - which she happily paid. What is wrong with our country that we just can't get this right? This Dr. in Apex, NC is on the right path. Hopefully it'll be an incentive for other Docs to start as well. I'd go in a second to someone like this.

Home Health Columnist / Guide

NRSKarenRN, BSN, RN

10 Articles; 18,305 Posts

Specializes in Vents, Telemetry, Home Care, Home infusion.

Issue is for those WITH insurance, by doctor not participating with insurance companies,

patients are UNABLE to get services covered i.e paid for by insurance....especially if managed care or Medicare.

This includes radiology, CAT Scans, IV infusions: IVAB /pain meds, referrals to specialists, orthopedics, minor office surgery, and medications if in a HMO etc.

elkpark

14,633 Posts

Issue is for those WITH insurance, by doctor not participating with insurance companies,

patients are UNABLE to get services covered i.e paid for by insurance....especially if managed care or Medicare.

This includes radiology, CAT Scans, IV infusions: IVAB /pain meds, referrals to specialists, orthopedics, minor office surgery, and medications if in a HMO etc.

That was my thought, too -- it sounds like a great idea, but if you need anything other than (more than) seeing him in the office and getting a scrip, you're still out of luck ...

Home Health Columnist / Guide

NRSKarenRN, BSN, RN

10 Articles; 18,305 Posts

Specializes in Vents, Telemetry, Home Care, Home infusion.

nurse pratcitioners are providing these type services at your local pharmacy in many areas:

cvs minuteclinic locations

rediclinic - high-quality, affordable healthcare for routine conditions

walgreens take care - take care health centers - providing high-quality

the little clinic - home

most have insurance contracts too.

SDALPN

997 Posts

Specializes in Peds(PICU, NICU float), PDN, ICU.

He encourages people to get insurance for major issues. He believes that insurance is for the major problems. He compares it to car insurance. He says you don't get car insurance for maintanence (oil changes, tires, etc.) you get it for the bigger issues. Same with people. They don't need insurance for the maintanance (physicals, etc.). They need insurance for the major things. This is what health insurance was originally for. But over time things changed.

Guest717236

1,062 Posts

nurse pratcitioners are providing these type services at your local pharmacy in many areas:

cvs minuteclinic locations

most have insurance contracts too.

i can not speak to the other clinic choices, but i was disappointed in minute clinic.

last year i presented with mycoplasma pneumonia. i saw the np who said

she could not treat it and referred me back to my md. he is located in another state, but about 45 min. drive. we had a snow storm which is

why i went to the clinic.

because she sent her evaluation, he called in a script for me.

he was very upset as to why she could not treat it as he has an np in his office.

the expanded role isn't much help if your parameters are very strict.

jjjoy, LPN

2,801 Posts

He encourages people to get insurance for major issues. He believes that insurance is for the major problems. He compares it to care insurance. He says you don't get car insurance for maintanence (oil changes, tires, etc.) you get it for the bigger issues. Same with people. They don't need insurance for the maintanance (physicals, etc.). They need insurance for the major things. This is what health insurance was originally for. But over time things changed.

I tend to see it that way as well. For insurance to work you need a large pool of people who probably won't need the service in question. Health care is something most everyone WILL need at some point. Those with pre-existing conditions will DEFINITELY be needing health care services. In either case, it's not insurance that people need, it's health care itself that they need.

So the question isn't how do we ensure everyone has access to affordable health insurance, it's how to ensure that everyone has access to affordable health care. And that's not an easy question to answer. It involves determining how to make very expensive services available at an affordable rate (whether billed to individuals, private health care collectives aka insurance companies, or government programs) while still ensuring that providers can make a living and have viable businesses offering these services and developing improvements.

What's considered affordable and what's considered a reasonable profit margin? I imagine a lot of disagreement there.

tralalaRN

168 Posts

Specializes in pediatrics.

Oh, I agree that this is not the answer to all health care needs, but for those without insurance, or those of us who have a major medical policy only, those out of pocket costs for routine things like sinus infections, UTIs, check-ups, lab work etc can run into the thousands of dollars each year. This is great. I'd use it if there were a clinic like this in my area. Most definitely. I'm not comfortable though with going to an OP clinic like a Minute Clinic though - probably because this is more assembly line-like medical care. They most certainly have strict parameters and limitations to their care, whereas a private MD office can have more flexibility.

I had seen this earlier tonight also, and was very impressed by this Dr's practice. No nonsense - how simple it should be to receive medical care. Not all this hoop-jumping!

On an aside - my daughter was visiting in France recently and became ill with what we thought was probably a sinus infection. She was resisting going in to be seen/treated, as she thought that without being a citizen, being out of the country and dealing with insurance in a foreign country, that she would end up paying so much. Well, she finally broke down and went in. The entire visit - to diagnose *and* tx w/ antibiotics - $60 - which she happily paid. What is wrong with our country that we just can't get this right? This Dr. in Apex, NC is on the right path. Hopefully it'll be an incentive for other Docs to start as well. I'd go in a second to someone like this.

This is an interesting point and mirrors our experience in France almost exactly. We were on a 3 week bike tour and my wife came down with a bacterial bronchitis. Thinking of what a hassle an ER visit is in this country, we put off seeking care as long as possible, and it was a national holiday when my wife finally decided she was too sick to keep that up. I went to the hotel desk and they made a phone call to find out who had primary care call for that town on that day. An hour later we were in the office and the whole deal cost 46 euro for the visit and another 25 for the drugs - the visit cost was double the usual because it was a holiday. More notably, the office was very nice but small - no office staff, and no need for any. Much like in the "Direct pay" office. Note that this is a country with a national insurance system that covers everyone, so if we were citizens there would have been little or nothing to pay. We just paid cash for the small bill, but I asked the doctor what would have been involved if we had been citizens: a one page form with space for pt's name and diagnosis and the doctor's signature. And the same form for every patient, not the hundred different ones we deal with here.

The total national expenditure for health care there is about 60% of ours, whether you figure it as per capita or a percentage of GDP, with more doctors per capita, longer life expectancy, no one micromanaging what the doctor orders. They do seem to have gotten some things figured out pretty well.

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