About a month ago I attended the annual conference of the Society for Innovative Medical Practice Design (SIMPD), a national organization of physicians like me who have decided to stop working for insurance companies, and start working for our patients. The conference was very inspirational. We heard distinguished speakers including Tommy Thompson, former Secretary of the Department of Health and Human Services, Regina Herzlinger, Professor of Business Administration at the Harvard Business School, and Connie Mariano, M.D., who was White House physician to three sitting American Presidents. Their presentations had a common theme: American medical care is in serious trouble. We heard that health care is increasingly expensive, physicians are increasingly overworked and demoralized, and patients are increasingly frustrated by the inadequate time, attention and education they receive. The solution will not come from government or from insurance companies. After all, they created the problem. The solution will come from empowering patients to spend more of their healthcare dollars directly, and giving them increasing options of how to spend them. In this context, physicians who sever their relationships with insurance companies and work only for their patients will be an important part of the solution. We will revitalize patient expectations, provide examples of a fulfilling career to the next generation of medical students, and remove ourselves from the diminishing stream of insurance reimbursements. In short, we will be good for patients, good for other doctors, and good for the nation.

Hearing the speakers was very interesting, but even more enjoyable was meeting the other physicians who attended the conference. I was impressed by what an idealistic (and fairly young) bunch we were. The doctors I met had very similar stories. Many were frustrated at having to see 30 patients a day. Some were on the verge of dropping out of medicine entirely before discovering this new practice model. Some were motivated by extra time to spend with family, some by the nagging realization that they were not delivering good care in their high-volume practice, some by the desire to abandon the complexities of insurance billing. I almost never heard income mentioned as a motivation. These doctors aren’t in it for the money. They’re trying to reclaim their profession.

A question that I frequently heard asked by the doctors was “What should we call this kind of practice?” Small patient-focused medical practices have been called “concierge medicine” or “boutique medicine” but neither of those terms was very popular with the doctors. “Retainer-based medicine” has also been used in media articles about such practices. SIMPD uses the phrase “patient financed medical care” which is more descriptive, but is too long and hasn’t caught on either. Business and policy articles have begun using the phrase “consumer-driven health care”. For example, the National Center for Policy Analysis, a free market think tank, recently released their analysis paper Consumer-Driven Health Care Spurs Innovation in Physician Services.

Eventually I think it will be patients who settle on a name for this kind of practice which is patient centered and patient financed. I’m honestly curious what you think of the various names, or whether you have a name that you think is better. Please send me your thoughts. Since you’ll be responsible for fixing American healthcare; you might as well decide what to call the solution.