Not one single Retirement Community in Idaho (Independent or Assisted Living) has regularly scheduled on-site doctor services offered to all their residents…not one! Despite the potential value of these services, not only to the residents but also to the Communities, until now there has been no focused dialogue between doctors and Community administrators to try to bridge this gap.
I’d like to explain, from the doctor’s point of view, why this service does not happen. I will then point to a solution that works for EVERYONE with the hope that we will all work together in partnership to help the elderly who need us.
The short answer? Going to Retirement Communities contradicts the doctor’s current business model. Even though many might desire to extend their practice to include these Communities, they simply can’t because doing so is 180 degrees in opposition to their business model and therefore prevents them from running a profitable medical practice.
Here’s the doctor’s perspective:
- I can either remain in my office with my entire support staff who has arranged a full afternoon schedule of patients waiting in exam rooms to see me, or
- I can spend the entire afternoon traveling to a Retirement Community where I have no support staff, have to hunt down my 1 or 2 low reimbursement Medicare patients wandering around the Community somewhere, find some place to examine them, and then somehow arrange follow-up testing and appointments.
Everyone simply accepts that if you need a doctor, you go to the doctor’s office, to a clinic, or to the hospital. The doctor does NOT come to you.
Here’s the dilemma
Healthcare is changing, and this means that doctors and Retirement Communities must adapt to new ways. In order to reduce overall healthcare costs, there is an increasing focus on delivering as much healthcare as possible OUT of institutions (e.g. hospitals) and in the Community.
Here’s how doctors must change
You must be more creative and develop a business model that encourages you to come out of your office and provide care in our Communities. There’s a HUGE need and desire for this, and it must be met. Especially for the elderly for whom scheduling appointments and arranging transportation is so difficult that they will often avoid essential medical care rather than go through all the hassle.
Here’s how Retirement Communities must change
Your market is extremely competitive, and in order to achieve a profitable census Communities must not only attract residents but maintain their loyalty by offering quality services. When available, on-site healthcare MUST be included. You must invest in this service just as you would invest in other valuable services you provide.
Here’s a solution
Doctors and Retirement Communities must come together as partners, not competitors. They must understand that neither is trying to take advantage of the other. Rather, both are working together, in partnership and to their mutual benefit, to care for the elderly.
Doctors in Boise, Idaho have ‘stepped up to the plate’ and met this challenge by developing a new business model that makes it possible to provide regularly scheduled services to all residents of a Community while maintaining a profitable medical practice.
But this new model requires that Retirement Communities must also ‘step up to the plate’ and invest in a service that their residents want and that will benefit them and make them more profitable by raising their census.
A partnership that includes Retirement Communities, their residents, and doctors, is one in which EVERYBODY WINS!
Dr. Steven,
Kudos on a well written, well thought out, and NEEDED proposition. 40 years ago I consulted as a pharmacist and had to sign off on (along with MD and D.O.N.) EACH chart/pt once each month–state Law in AL at that time. Both the MD and I were paid proportionately for our services. In today’s CMS world, not so. After researching MY new role providing products, I can tell you MOST good facilities are looking for a marketing advantage…even with lower Medicare reimbursement. Your suggestion is a win-win-win. Doctor increases exposure to new patients…including family members of the resident. Nursing Home gains prestige (read marketability) from such a program as yours. PATIENT gets needed medical care; seamlessly.
Don Hamlin, President Rehab Results LLC
Don – thanks so much for your support and comment. I agree that when we partner together, everyone wins. We need to be innovative and create these opportunities privately, OUTSIDE of, but still working with, our current medical system. We can’t wait for Medicare or some other government intervention to improve our healthcare delivery to Retirement Communities, because it will never happen. On the other hand, with partnership, we can make a difference NOW, TODAY.
I appreciate you being part of this discussion, Don.
Our Communities are very unique in the Houston area. We are beautiful Family Oriented and “secure” Assisted Living Communities focused on memory support. We have four or five Geriatric doctors (and their Nurse Practitioners)who come in to the community to see residents on a regular basis and when needed. This helps us keep residents healthy and is proactive. We rarely send a resident out unless it is a true emergency. We have a double licensure and can handle many of the testing procedures that would normally be done in a physician’s office.
Dana – how lucky you are! Very few Communities have the kind of support you describe. Your experience affirms the importance and value of having doctors and NPs on-site. This is the kind of system I am creating here in Idaho, and I hope I can replicate your success.
Thank you so so much for telling us about your experience.
Dana, My campus in Arlington Tx (IL/AL/MC) is one of the fortunate ones also. We have 3 physicians that come on a regular basis, one of them comes weekly he has about 40-50% of our Residents. It helps us with longevity and a decrease in ER visits. We are able to contact all 3 of them 24/7 for any emergency. This also gives those family members who do not live close by peace of mind. 1 out of 5 of our new Residents often switch to one of these physicians d/t residents not having to go to an office to be seen, which is very hard sometimes on the residents with Dementia
What a terrific Community you have, Deborah! Something that helps your physicians to maintain their interest is that many of your resisdents consider them their PCP. A question for you: do any of your physicians serve in a medical director role or have some other salaried position with your Community?
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