Drs. Faisel Syed of and Dan McCarter of ChenMed medical group invited me to participate in a podcast on “Optimizing Medical Treatment.” ChenMed is a fascinating company. It is a family owned, mission-driven primary care practice. There is no venture capital involved. They take care of disadvantaged Medicare Advantage patients, and their sites are generally in the same neighborhoods as federally qualified health centers (FQHCs). These are the highest risk individuals. ChenMed takes on the total risk for the patients that they treat. They currently have 350 providers, and they expect to quadruple their force in the next three years.
They understand that healing depends on relationships. The number of patients in each doctor’s panel is limited to 450. The average number now is in the 375-400 range. They share their cell phone numbers with patients. The office contacts the patient once a week. The doctor sees the patient once a month. They understand that most costs in this population come from emergency room visits which then lead to hospitalizations. Hospital medical error before covid was the 3rd leading cause of death in the US. Their whole system is designed to keep patients healthy so that they do not need to be hospitalized. Their model is successful enough to allow the rapid expansion I described above. They are proving that we cannot have better health at lower cost in a fee-for-service system. We must move much more quickly to full risk value-based care that rewards keeping patients well rather than rescuing them in a crisis. It is imperative that primary care physicians both have “skin in the game”, but also reap the rewards for preventive care that can then be reinvested for either further improving care or providing care to more patients.
This makes sense. In the early 2000s, I worked with a major nonprofit to lobby for better healthcare. One of our issues was better patient advocacy to prevent misdiagnosis and resulting death, both in and out of hospitals. Since moving back to SC, I have found that some doctors, even relatively young ones, do not consider me a partner in my healthcare or decisions about them. I either correct that assumption or switch doctors. No one knows my body more than I do.