My Unique Pay-It-Forward Model
Your health is priceless, right? But our conventional system puts a price on health care all day long, without any transparency at all.
So what if, instead, there were no price placed on your health care? What if your care were gifted to you by someone who had paid it forward for you? And if so moved, you then offered to pay it forward in the same way, for the next person seeking care?
That’s how my practice now works. I don’t know of any other gastroenterologist in the world who is operating in this way (if you do, please let me know — I would love to connect).
Before I explain the model further, let me tell you how I got here.
Freedom to Serve You, as You Deserve
My goal has been to serve my patients with the utmost personal, professional care. For me, the foundation of that care will always be the patient-doctor relationship. I hold that relationship to be sacred. That relationship is what builds trust between me and you. That trust allows both you and me to be accountable to each other. You bear the responsibility to help yourself to health. And I bear the responsibility to guide you.
But something has been inserting itself deeper and deeper into the patient-doctor relationship.
It’s undermining the sanctity of that relationship. And it’s become the 800-pound gorilla in the room.
That something is health insurance companies. Health insurance companies that dictate what doctor you get to see – and what doctor you don’t. That decide what treatments are usual, customary, and reasonable – and what treatments aren’t. That influence with those decisions what you and I, discussing with each other, feel is best for you. And that determine what the price of medical care should be – and when you should be informed about it.
Take your auto insurance, in contrast. Does your auto insurance tell you what mechanic you have to visit? Does it restrict what your selected mechanic chooses to fix your car? Does it make you choose not to get an oil change to maintain your vehicle – just because it doesn’t pay for it? And does it fix the price of your mechanic’s services?
You wouldn’t accept this for your car, would you? Why would you choose to accept this for something much more important – you?
It’s not that health insurance companies don’t at all have the interests of you and me in mind. It’s just that they answer first to their shareholders. And, in the age of Obamacare, to the government. You and I fall behind.
I no longer wished to answer to both you and your insurance company. I want to answer to you, and you alone.
So I declared my independence and no longer participate in any health insurance networks. This includes Medicare, Medicaid, and private insurances.
Then I came upon ServiceSpace, an organization that has been promoting an ecosystem of gifting for years. They call it “giftivism.” One of the best examples is Karma Kitchen, a restaurant where the check at end of your meal reads zero. It’s zero because someone before you paid for your meal, and you get to pay it forward for someone after you. It’s not about giving food away for free, like a soup kitchen where the food is paid for by an external agency. It’s about creating a space to cultivate a shift in which we no longer know who’s the giver and who’s the receiver.
ServiceSpace was doing this in restaurants. I figured, what better place to do this than in health care?
You see, I believe the patient-doctor relationship is a unique expression of love and healing – both for me as well as you. My greatest joy is to help you get to the position of not needing my services anymore. And I believe this shift, to a new way of practicing medicine, will renew the joy that called me in the first place to this hallowed profession.
Anything that honors the unique expression of love and healing that is the patient-doctor relationship, I am choosing to promote and preserve. Anything that doesn’t, I am choosing to disturb and discard.
That is my sacred commitment to you. That is what you deserve.
What You Can Expect with this Shift
All the time you need: I have always spent more time during patient visits than most other physicians. This has not changed. In fact, my time with patients has increased. Because my staff and I spend less time calling insurance companies on the phone and asking you irrelevant questions just to fulfill questionable government mandates.
Helping you get to the root: In health care, America is a wonderful place for plugging holes in the dam. It’s not so wonderful a place for fixing what’s going on behind the dam.
Having done all my medical training at Baylor College of Medicine in the world-renowned Texas Medical Center, I’m well-versed in acute care medicine.
But I want to help you go from acute care medicine to root care medicine.
I’d like to guide you to address the root causes of your health conditions – not just stumble from one health crisis to another. And this shift much better allows you and me, together, to achieve just that.
The treatment plan unique for you: I offer you services based on your unique needs, not what some insurance company decides to pay for. Because there is no such thing as “cookbook” medicine.
Transparency in what you pay: No other industry is as complicated and confusing on prices as is health care. It’s ridiculous. I am upending this whole game by giving you freedom to decide how you wish to pay it forward. Some of you may need a frame of reference for how to contribute. Below are suggestions based on my prior fees (scroll the table to the right if you’re viewing on a smartphone):
If you are on Medicare: For those of you NOT on Medicare, any out-of-network benefits you have may allow your insurance carrier to reimburse you for my services. You will be responsible for filing a claim for your insurance, but we can help you with the information you may need to file the claim.
If you’re on Medicare, I can still see you and certainly hope to care for you. But it will be outside of the Medicare payment system. Because of Medicare regulations, you will not be able to file a claim for my services to Medicare or Medi-Gap for reimbursement. I will also need to keep on file a private contract between us that allows me to see you. It’s not a complicated contract, and you can find it in the Patient Forms section of the website.
I apologize for this. This is as absurd to me as it may be to you. You don’t need a contract with your grocery store to purchase food, and you shouldn’t need a contract to see me or any other physician. But these are the rules of the federal government I must abide by.
Please note that there will be NO change in your Medicare benefits. You can continue to use your Medicare and any secondary insurance benefits for labs, X-rays, hospital expenses, and services you receive from doctors contracted with Medicare. The change only applies to my care.
From transaction to relationship: It’s not called the patient-doctor transaction. It’s called the patient-doctor relationship. That relationship is at the core of all of health care. Without it, our whole system of health care is lost. On the inside of the patient-doctor relationship is trust. And on the inside of trust is nothing other than love.
For me, this is an experiment in outrageous love. I am fed up with our current health care system, one that pits left against right in a seemingly endless game of partisan politics. But health care also shouldn’t be some mushy bipartisan compromise or some apathetic nonpartisan settlement. Health care should be trans-partisan. Sometimes it may go left, and sometimes it may go right. But it’s beyond left and right. Those terms are irrelevant.
First and foremost, health care should express HEALTH and CARE. I serve you in health and care. It’s a way of serving that you simply will not find in other medical practices — one of time commitment, root care, unique therapy, and priceless pricing. And I trust you too will serve me in health and care. I don’t succeed without you. In this interconnected relationship we will heal each other, together with our community. And health care will never be the same.