Reality of "The System"
So you called up your regular doctor today and asked to be seen, you weren’t expecting to be seen that day but you had a glimmer of hope... The receptionist answers and lets your know that the doctor has a 15-minute opening in…3 weeks. You look at your schedule and realize there’s no way you can make that work without completely rearranging your schedule. “Do you have anything else?” You ask the receptionist. She responds with “How about 11 am in 4 weeks?”. Realizing that’s the best they can do you accept and patiently wait for your appointment. When you get there, there are 5 other patients waiting for their appointments as well. One by one they get called in and eventually after an hour you get called in as well. The medical assistant takes your vitals, rooms you, and then you wait… again.. Eventually, your doctor comes in to talk with you. After about 10 minutes you’re on your way out the door towards checkout and you’ve been asked to follow up in a month.
Does this scenario sound familiar to you? It should. It’s pretty much the standard of how medical practices operate these days. It is the result of decades of evolution in the healthcare system, insurance, reimbursement schemes, and government intervention. That’s not to say that any of these things are bad, but the combination of events has led to an unstable market that has resulted in many of the problems and strife we see with healthcare today.
So let's look at the above scenario. Why, exactly, does it take 4 weeks to see your healthcare provider? Why, exactly, can’t they see me on the same day? The answer is simple. Volume. As providers in the traditional system, we operate on a model known as “Fee for service”. This concept is exactly what it sounds like, when we offer a service, we bill you at the time of service. This model has been the core of medical care for generations in the United States and the result of if we are paid per patient, then the obvious way to make more money is to see more patients each day. On average, the typical provider in the United States must see between 20-30 patients per day for the practice to remain profitable. Over the years, administrators have learned how to game the system. They learned to make the visit more efficient, the addition of medical assistants, receptionists, office managers, and various other entities to break up the visit into smaller parts where each one handles a different part of the visit. They learned how quickly providers can see patients to maximize revenue, not to maximize the quality of care mind you, but to maximize revenue. This is where the standard 15-minute visit comes from. The result is a healthcare assembly line where you are ushered from one place to the next.
The problem is, people are not cars, we are not robots. We can't just be pushed around like cattle and expect to be happy with the system. We like to be heard, we like to be listened to. We like to form relationships with the people who are caring for us! Even as healthcare providers, bouncing from room to room, managing multiple patients at once, 5 minutes here, a couple of minutes there, at the end of the day… it’s exhausting. I don’t know that any of us got into healthcare for such an overload. The reality is, is that when you are seeing thousands of patients, it’s impossible to truly care for any of them. If you’re lucky enough to have been with the same provider for more than a few years they might remember you, but most are overloaded and are just trying to get through the day.
At my last job, I was responsible for 2,500 patients. I was responsible for seeing 25-30 patients per day. I was required to see them every 15 minutes. On average, I was booked out almost 2 months for a simple follow up. Each day I was behind by almost an hour, nearly every day working through my lunch. I finished seeing patients nearly 2 hours after I was supposed to have gotten off. And then I’d wander back to my desk to see my paperwork for the day. 30 charts to finish, 90 messages came in since this morning, 420 messages backlogged that I haven’t been able to keep up with. My nurse walked over to hand me a notice from the insurance company saying an MRI for one of my patients has been denied. Another notice telling me they won't pay for physical therapy. Another telling me that their formulary has changed and all patients with ____ insurance must now be switched over to a new medication… A single phone call to try and do right by my patients and get their MRI approved with the insurance company wound up taking over 45 minutes.
At the end of the day, the system is rigged. It’s not meant to make patients better, it’s not meant to make you healthier or happier. It’s been designed to maximize profits and revenue. One in six Americans have medical debt with a combined total of over $81 billion for Americans. At the end of the day, your doctors, your PAs, your nurses, and assistants. All the people who stood up in front of their peers with their hand up and took a solemn oath to do no harm.. are not the ones in control of your healthcare. The ones who took an oath to serve, who dedicated their lives to help and to heal have become controlled by big business. One of the reasons our healthcare system is broken is that the ones pulling the strings did not take the Hippocratic oath to do no harm. They are responsible only to their shareholders.
At Starlight Health, I did take an oath to do no harm. I did stand in front of my peers, colleagues, family, and friends and swore that I would uphold the ideals set forth by the medical profession. I made a vow that I would help, heal, and do no harm. And that includes not only medical but financial. I set up my practice so that all prices are transparent and affordable and to the extent of my abilities can save patient's lives and bank accounts. I chose to break away from “The System” and reimagine what healthcare should and could be. I started this venture to do my part to bring medicine back to its roots, to re-establish the provider-patient relationship, and to bring true healing into the lives of my patients. Join me on this adventure as we reinvent the American Healthcare System.
Jason Rogers, PA-C
Jason Rogers is a Family Medicine provider located in Fort Collins, CO. For a single monthly membership fee he offers unlimited access to his services. Patients can be seen as many times as they want, can call, text or video chat as much as they like. He will meet patients at their homes or anywhere else in Fort Collins. He is able to see individual adults, families or employer groups
His practice, Starlight Health, is a type of practice known as Direct Primary Care. To learn more about Direct Primary Care please go to: