I founded and still lead a company called “Think Patients”. You’d think a person with that background would have a pretty good handle on their healthcare. But it’s been about 6 years since I had a primary care physician despite having no obstacles to that other than an inability to find a decent one, in a practice I liked, and in which I could get an actual appointment for care without having to wait for weeks on end. This says a lot about the state of healthcare, and in particular primary care, in this country.

When Kate and I got married 25 years ago I had a fantastic internist. Kate ended up switching to him as well. He practiced in a university-owned health system considered one of the best in the nation, and all was well for several years. But we started noticing a change in the rate of staff turnover accompanied by a lack of patience from everyone in the system. No one knew us by name anymore. Then one day our doctor told us that he’d had enough of the pressure to see more and more patients every day, faster and faster. He was leaving to join the R&D department of a pharmaceutical company, and that was that. 

We switched to another provider in that system, and then followed him when he bought into a local private practice. We were never thrilled with the staff there, but when it got to the point that we were told to wait four weeks for an appointment even when acutely ill, we knew it was time to move on. Kate tried another practice or two, but I just drifted into using urgent care centers when necessary, and seeing specialists such as our dermatologist. Then Covid hit, we made our move to rural Maine, and discovered an area with a real shortage of physicians. The practices I wanted to join weren’t taking new patients, and after almost three years of being on what I’m all but certain are imaginary waiting lists. I decided I needed to take another approach. 

I expand my search to include areas further away, and that’s when I found a physician with a dramatically different approach. He’s an osteopath and osteopathic physician practicing “direct primary care”. This is what some people call “concierge medicine”. There’s no insurance involved. You pay a set fee each month, and in return you get a generous number of visits per year and, most importantly, a guarantee that when you’re sick, you’ll be seen, the same or the next day. Most visits are scheduled for 30-60 minutes. My first visit is scheduled for 90. The practice is 45 minutes away, but if appropriate, telehealth is an option. And rather than having to fill out a stack of forms to even be considered for admission to the practice, I emailed back and forth with my soon-to-be primary care physician, who answered all my questions about the practice and his approach to treatment thoroughly, promptly, and patiently. We use each other’s first names in conversation (you know, the way we do in almost every other aspect of our lives). I couldn’t be happier.

This is going to cost me a bit more because my high deductible health plan won’t reimburse me for the monthly charges. But I’ll have access to regular care from a physician who actually knows my name, and who seems genuinely interested in my health beyond just getting me back out the door so the next patient can take my place. And given that my new doctor still practices “real” osteopathy, I might finally have a way to get my too-often-achy body back in alignment. 

With some luck, and given our age differences, this will be the last primary care physician I’ll ever need, even if I last a few more decades. I’d be very happy if that’s the case, because it has damn sure taken a long time to find this one. I don’t think that say much for our healthcare system.