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When you see this symbol anywhere in this web site, it denotes something that a managed care doctor simply cannot afford the time to do for you because of the low fees he's being paid for your care.

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ESTABLISHED PATIENTS CAN ALWAYS GET AN APPOINTMENT TO BE SEEN IN OUR OFFICE THE SAME DAY THEY CALL
     If you are already a patient of our office, you have learned from experience that when you suddenly become ill and if you call us first thing in the morning, we will always find a way to get you in for an appointment that same day.    Has any other doctor's office ever consistently provided you that level of access and service?

MANAGED CARE DOCTORS: Just try to get an appointment to be seen the same day in most other doctors' offices, especially those which participate in "capitated" HMO programs whose primary objective is to keep you out of the office.

OUR OFFICE NEVER OVER-BOOKS
     Actually we deliberately "under-book" our advance appointments to be sure we always leave time for patients who phone early in the morning with urgent problems that must be seen immediately.    We never accept walk-ins (unless they are extremely ill); so you never have to worry that you'll be seen later than your appointment time because we "worked someone in" ahead of you.    On those rare occasions when we receive an unexpectedly large flurry of calls from sick patients all needing to be seen that day, we'll work right through our lunch hour or stay late rather than inconvenience you by double-booking the time reserved for your appointment.

MANAGED CARE DOCTORS: In many medical offices, patients have discovered that if they just walk in without an appointment and hang around long enough in the waiting room ("waiting" room is a good name for it, isn't it?) the staff will eventually slip them in between other patients even though the schedule is already packed full.    This guarantees that the schedule will slip farther and farther behind, and everyone involved will become increasingly rushed.    Not good.   And once patients learn they can "get away with" this walk-in behavior, they fall into repeating patterns that are very hard to break.

OUR OFFICE IS ALWAYS ON TIME
     As you know from experience, our office always runs on time.   If you have a 10:00am appointment, you know you can count on being seen promptly at 10:00 and can therefore plan to be back in your office by 10:30.    Have you ever before visited a medical office in which the staff makes it so clear they realize that your time is just as valuable as the doctor's?

MANAGED CARE DOCTORS: Long waits in the doctor's office have always been a running joke, and most doctors don't even give lip service to running on time.    Nowadays with low-paying managed care, the wait is even longer.    Take a number; take some old, moth-eaten magazines; have a seat... and wait.

WE ACCEPT VERY FEW NEW PATIENTS; SO WE'RE NEVER OVERLOADED
     I have had essentially a "full" practice for many years.    I made a conscious decision many years ago to restrict the size of my practice; so that I would never become overworked and thus lose the joy of practicing medicine and being closely involved in the lives of my patients.    Since most of my patients have been well satisfied with the care they've received in our office over the years, few ever leave; so we have only a very limited capacity to absorb any new patients.    Any time I begin to sense that the practice is becoming too large again, we stop accepting any new patients at all for a while until a few move away or leave us for other reasons (such as when their employer changes them to a health plan we refuse to accept).

MANAGED CARE DOCTORS: The plummeting physician fees due to "managed care" have caused many doctors to keep accepting responsibility for more and more new patients in order to try to make ends meet.    Some feel that the only way to survive is to keep working faster and faster for the lower and lower fees. This inevitably results in rushed, impersonal care.    I call this RUNNING ON THE MANAGED CARE TREADMILL TO MEDICAL MEDIOCRITY.

 WE ENJOY TAKING CARE OF YOU

ATTENTIVE STAFF
     Our office staff is a close-knit and happy team whose primary focus is to provide the most thorough and attentive health care possible to every one of our patients.    In this office, the patient has always come first and always will come first.

MANAGED CARE DOCTORS: In these days of impersonal "managed health care", the staff in many medical offices are often so rushed, overworked, and stressed-out that they become cross with each other and even with the patients; and you can feel the tension when you walk in the door.    You've probably experienced this yourself in other medical offices before you became totally spoiled by the warmth and caring of our staff.

YOU CAN SENSE THAT MY STAFF AND I LOVE WHAT WE DO
     The reason you always see me with a smile on my face is because I've never "sold out" to the managed care companies, never stopped doing what I think is right for my patients; and I have never allowed any insurance company to give me orders or tell me how to practice medicine.

MANAGED CARE DOCTORS: Because of the managed care debacle, many younger doctors are struggling to survive while trying to make the payments on their enormous educational loans.    Many have had to go on the payroll of large medical organizations and are thus totally controlled by non-physician administrators.    They are required to see large quota numbers of patients each day; and every test, prescription and move they make is scrutinized to cut costs and increase patient "throughput".    These doctors can be fired if they don't follow orders from their non-MD bosses.    Just imagine that, a doctor being fired because he spent too much time or effort caring for his patients!    These organizations, of course, are designed to cut spending, thus minimizing the care given to patients in order to maximize the profits of the insurance company.
     Many older doctors are still in private practice, but they are not in a financial position to retire and thus have no alternative but to work harder and harder to try to keep their heads above water.    They know they are trapped, and it wears them down over time.
     Neither of these groups of doctors nor their staffs are "happy campers", and you can sense it all around you when you're in their offices.

YOU ALWAYS CALL US FIRST, DON'T YOU?
     Even when you're having non-medical problems, you've learned from experience that you can depend on our staff to do everything possible to help, no matter what the problem may be.    When you're having problems with your insurance company or some specialist, isn't it usually our office you call for advice or assistance?    Why?    Because you know we care, and we almost always get the results you want.

MANAGED CARE DOCTORS: You've learned to have low expectations for service and genuine caring.

   WE'RE PROFESSIONAL AND THOROUGH

IN OUR OFFICE YOU ALWAYS SEE THE REAL DOCTOR,
NEVER A DOCTOR "SUBSTITUTE"
     I have always enjoyed having a close personal relationship with all my patients; and I feel that if you have a health problem you feel is serious enough to warrant a visit to a doctor's office, then you deserve to be examined and treated by a real MD.    As long as you are a patient of this office, you will never be examined or treated by anyone except me personally.

MANAGED CARE DOCTORS: With insurance reimbursements as low as they are these days, many doctors have allowed their practices to become overloaded and overbooked with hoards of patients from low-paying health plans.    In order to handle their enormous daily patient volumes, these doctors often employ either a Nurse Practitioner (NP) or a Physician's Assistant (PA) to quickly examine and treat much of the patient overflow.    A well-trained NP or PA is certainly capable of treating certain health problems while under the supervision of an MD, especially in rural areas where there is a serious doctor shortage; but you won't ever be treated by one in this office.

I TAKE EXTRA TIME WITH MY PATIENTS
     You know from experience that I always take as much time with you as necessary to be sure you fully understand the nature of any acute medical problem, the reasons for the tests to be done, the proposed treatment, and what you should expect during the recovery process.    I feel that every one of my patients should be an "Active Participant" in his or her own health care, not a "Passive Recipient" of health care; so when a patient has a chronic problem such as hypertension or diabetes, I always spend a great deal of extra time carefully educating the patient about the nature of the illness, the cause(s), the eventual consequences if left untreated, the treatment(s), the required periodic testing and monitoring, and the expected long-term outcome if treatment is successful.

MANAGED CARE DOCTORS: Plummeting physician reimbursements have forced most doctors to rush more and more patients through their offices every hour just to try to make ends meet; so there's simply no way the doctor can take time to really talk to you.   
     I read recently that primary care doctors now spend an average of only 5.8 minutes with each patient!    That's 10 patients every hour.    Since that's an average number, then obviously for every visit lasting more than 5.8 minutes there must be one that's shorter than 5.8 minutes!   
     I have never in my 30 years of medical practice ever scheduled more than six patients per hour in my office; so I find that 5.8 minute average absolutely appalling!     Obviously those doctors have no time at all for patient education, concerned hand-holding, TLC, and certainly no time for "idle chit-chat" about personal matters.    You've probably been herded through that kind of office before, but there is no way in the world that I would ever practice medicine that way.

I CHECK EVERY LAB AND TEST RESULT MYSELF
     I feel very strongly that I should be the only one to review every single lab and test result on every one of my patients.    I immediately give my instructions to the nurse to convey to you, and then write or dictate the more important findings into your chart.    This takes extra time for me, but my personal attention to every detail of your care insures that even the most subtle abnormality is noted and appropriate action taken.    Not even minor problems are ever given the opportunity to "slip through the cracks."

MANAGED CARE DOCTORS: Many medical offices are so rushed these days that lab results are reviewed and filed in the patient's chart by a nurse or even by staff persons with no formal medical background at all.    Often the doctor never even sees your results at all (!) unless the person reviewing the lab report happens to think a result might be abnormal and brings it to the doctor's attention. That's pretty scary, isn't it?

WE ALWAYS DO OUR WORK ON TIME
     Our office always completes all patient business by the end of every day -- we never hold over important duties from one day to the next.    When your pharmacy calls for a refill authorization, we check your computer record and OK the refill immediately.   When we receive a request from another doctor for copies of your medical record, they're on their way by fax at once.   When you need the paperwork for referral to a specialist, we complete our part and fax the information to your insurance company within minutes - any delays that occur are due to insurance company red tape on their end.

MANAGED CARE DOCTORS: The staff in many medical offices have been so beaten down and harassed by the breakneck pace and managed care paperwork headaches that they often become indifferent to patient administrative problems and concerns.   Such paperwork "chores" often end up being postponed for several days (or forgotten) while patients are forced to wait... and wait.

WE ALWAYS CALL YOU BACK PROMPTLY
     When someone in your family has a medical problem, the last thing you want is to spend the day waiting by the phone hoping for a return call from the doctor's office (which often never comes).   When you phone our office with any question or problem, we make every effort to insure that we get back to you with an answer as soon as possible, usually within an hour or two, but certainly before the end of the day.

MANAGED CARE DOCTORS: Sometimes that return call from the doctor's office arrives many hours later, sometimes a day or two later, sometimes never.   This is understandable when you realize that under managed care many doctors have accepted far more patients than they can possible handle well in order to try to make ends meet.   These doctors' offices are absolutely swamped with calls from patients demanding advice, treatment over the phone, or appointments (when none are available).   The poor staff become overwhelmed by all this chaos; so it's no wonder they have trouble returning your phone calls.   They're stressed to their limits and can hardly wait to blow out of the office at 5:00, whether they have returned all patient phone calls or not.

WE KEEP EXCELLENT RECORDS
     Have you ever noticed how neatly typed and carefully organized your medical chart is in this office?    As soon as I step out of the exam room with you, I immediately dictate all the important details of your visit into the record; and this is then typed before the end of the day.   This sort of attention to detailed documentation says a lot about our attention to every detail of your care.   Clear records make it easy for us to keep track of every aspect of your health care, and it also makes our records easily understandable to any specialist or other doctor to whom we may send them.

MANAGED CARE DOCTORS: Just take a look at the scrawled, handwritten, abbreviated medical charts in many doctors' offices.   Much of it is illegible, even to other doctors; and many important details never get recorded at all because of the time required to handwrite them.   As doctors and their office staffs become ever more rushed by managed care, good medical record keeping falls by the wayside; and this increases the risk for serious errors to occur in your care.

I REFUSE TO ALLOW ANY INSURANCE COMPANY TO LIMIT THE QUALITY OF CARE OR THE AMOUNT OF TIME I SPEND WITH MY PATIENTS

I TAKE NO ORDERS FROM INSURANCE COMPANIES
     Everyone has heard horror stories about insurance companies forbidding doctors from telling patients about treatments that might be helpful to them.   You've heard how the managed care plans provide powerful financial incentives to doctors to try to reduce and restrict the care patients receive.   I can tell you from personal experience that the managed care companies apply enormous pressure on doctors in many ways to try to force us to limit and dilute the quality of care we provide to our patients.
     My patients needn't worry about this happening to them while they are under my care because I am employed directly the patients I serve; so I have no conflicts of interest.

MANAGED CARE DOCTORS: Some doctors, like the fictional Dr. Faustus, have "sold their souls to the devil" of managed care.    They now draw fixed corporate salaries: and they must take orders from non-medical bureaucrats who control everything the doctor does, restricting patient care as much as possible to enhance corporate profits.   Never mind about the Hippocratic oath...   These doctors have a very clear understanding that they can and will be fired immediately if they ever dare to challenge their corporate bosses' quest for higher profits and executive bonuses.
     Patients usually have no way of knowing when this is happening!