Time to Sign Up!

I've delayed this as long as possible, but can delay no more: it's time to open up the sign-up for the practice.  This has taken far longer than I anticipated, and I apologize for the wait.  Please understand the following:

  1. I will add new patients to my practice off of this list.
  2. Getting on this list does not obligate you to become my patient.
  3. Getting on this list does not mean I am your doctor.
  4. Getting on the list early will make it more likely you will get into the practice sooner, but there will be other criteria I will use to determine which patients to accept when.
  5. Please, please, please do not wait to get medical care because your name is on this list.  If you have chronic medical problems, get them taken care of.  If you are having a problem, get seen.  Don't wait for me to get care.
  6. Reread #5 to make sure you've gotten the message.
  7. I will begin to contact people as soon as everything is ready to start seeing patients.  This will be a process that will not happen at once.
  8. I will do my best to keep everyone on the list up-to-date with their status.
  9. If you aren't on this list, you can't become my patient.

There are two ways to sign up:

  1. Go to http://doctorlamberts.org/signup/ and fill in the form.
  2. Send a the following information to my office, at 119 Davis Road, Suite 4A, Martinez, GA 30907: Name: Address: Phone Numbers: Date of Birth: How many household members are signing up: Names and ages of family members: Were you a previous patient of mine?

Thanks again.  It's getting close, but there's a lot of work to do.

What it's Going to Cost

OK, I've told a bunch of folks already (and nobody punched me or fainted, which is a good sign), so I'll take this opportunity to announce the fee-schedule for my practice. The monthly fee is paid at the start of the month, giving access to care, communication tools, web content, etc.  There is no discount for paying a year in advance, it's confusing and it gives me one extra thing to keep track of, so I prefer a monthly fee.

The charges are:

  • Age 0-2: $40/month
  • 3-30: $30/month ($10/month if they are away in college)
  • 30-50 $40/month
  • 50-65 $50/month
  • 65+ $60/month

Family maximum will be $150/month

Registration fee is $50 for 0-30 years of age and $100 after that (will count as first month's payment). $200 Family maximum for registration.

I am really trying to keep it as affordable as possible, especially for families.  Registration IS NOT YET OPEN, but I promise I am getting there.

Newsletter for October 9

I sent out the following to everyone who signed up for the newsletter.  If you didn't get it, you either didn't sign up or it got sent to your spam.  Even though I'd love to treat the folks who followed the rules as an elite group, I will resist the temptation.  If you did get the newsletter you can consider yourself "elite" if that makes you happy. Here's what it said:

Hi!

Here's an update on how things stand with Dr. Rob Lamberts, LLC

1.  Video

Don't worry; I haven't forgotten about those of you who could not make it to the meeting on the 29th.  I am working to get the video recording of the talk put together with the slides.  It's a bit more complicated than I expected, but it should be up by the end of the week.

2.  Where will I be?

I am also hoping to nail down a location within the next 7-10 days.  It's important to me that this be done so I can make cards, brochures, and start working on it as soon as possible.  Thanks to everyone for your input on this!

3.  How much will I charge?

I want to be 100% sure of the numbers before publishing them, but I think I've got this figured out as well.  I have noticed hesitence on the part of the younger people and those with children, so I am doing what I can to keep that cost down.  Once I come up with a price list I will also open my "official" sign-up for the practice.  Those of you who filled out cards at the meeting on the 29th don't need to worry, as I've already got you on the list.

4.  When will I open up to start seeing new patients?

As soon as I can!  My hope is to start accepting patients as early as December 1 (no promises on this, though).  I will need to do the sign-up process in a slow and steady fashion (at least at the start) so I can be sure to meet people's needs and deliver on the service I want to give.  I ask you all to be patient in the process, as it is most important to me to do this well.  I want to exceed expectations, offering a truly new kind of care for anyone who is my patient, and one that is well worth the cost.

Thank You

Yesterday was a big day.  A lot of my patients received a letter that probably shook them up - a letter I was very apprehensive about.  Not only am I leaving Evans Medical Group, but I am doing so fairly soon (and I will explain the reason for that soon).  I was afraid of the reaction I would get, given how important a primary care doctor is to many patients, and given the relationship I've built with people over the 18 years I've practiced. But the response was not only better than I expected, it was downright touching to me.  Yes, I am sure that there are people who are angry and very worried about how this will affect them, and there are people who are disappointed by this big disruption in their care.  But an overwhelming number of people expressed real happiness for me as a person, that I was making a change and doing what I thought was the right thing to do.  It is wonderfully encouraging to be supported in such a way by my patients.

Thank you for not only choosing to have me as your doctor, but for the fact that you see beyond the title to the person who sits on the other side of the stethoscope.  I am most fortunate to have such good people as my patients, and hope to show that gratitude by making my new practice that will exceed expectations.

Collaboration

Most patients have to figure out how a practice works and adapt themselves to it.  If the phones have voicemail, they need to figure out how to get through the voicemail maze.  If patients are rescheduled after showing up late, they need to adapt to that too.  Most of these rules are put there for a good reason, but the word "good" is usually from the doctor's perspective, not the patients'.  


I want to change that.  One of the advantages of starting from the ground up in a practice style that frees me from the rules that usually constrain a practice is that I can do whatever I want.  Or, more specifically, I can do what my patients want.  I'm not saying that I won't have say in the process; I plan on giving my patients - especially those who start out with me - a huge hand in voicing their opinions of how the practice can serve them best.  I am not worried that they will turn me into their own personal "doctor slave," since most of the folks who join me are doing so because they are fond enough of me that they are willing to take a risk on my dream.  I am also not worried that there will be bad ideas that make things worse.  None of us have done this before, and sometimes the only way to figure out if something works is to try it.  If it seems reasonable, then we'll try it.  If it is a bad idea, we will abandon it and see what we can learn from the "adventure."

This will be one of the big bonuses for those bold enough to be with me from the start: you will have a hand at shaping your own health care.  The reason I am doing this is not, however, just to be a nice guy and give up my usual "power," it is to hear ideas from the other side of things.  I'll listen to any suggestion and hold regular debriefing sessions for patients to see how things are going.  How will I get suggestions?  How will I hold debriefing sessions?  How often will they be?

I don't know.  I am open to suggestions.

Who is the Ideal Patient for Direct Care?

There are some people for which the business model of paying a predictable amount every month is very well suited.  The current payment system hurts people because it forces people to be seen for even small problems, and charges a premium amount to ensure collecting the contracted amounts.  It's complicated, and it is a bad system for both patients and doctors. Who is my new model best for?

  • People with no insurance.  This is a no-brainer, as the low monthly payment is far more palatable and less risky.
  • People with high-deductible insurance.  This is the same as the previous one, as for most people, high-deductible insurance is pretty much a guarantee of paying cash for most of your care (unless you are very unlikely).
  • People from far away.  If you have to drive 50 miles to come to a doctor you like, you will spend a lot of money on gas (not to mention the time spent) to go to and from the doctor.  Having a practice style which emphasizes electronic communication will cut way back on all of this.
  • People who are healthy and want to stay that way.  I will be very aggressive at trying to keep all of my patients up to date with their care plans, allowing them to have resources to keep well and keep away from care altogether.  Yes, I am trying to decrease use of health care, which is a unique position a primary care doctor can hold.

Are there more who it works for?  Perhaps people who are unable to transport easily, or those who have jobs where they can't leave work without causing lots of trouble?  Let me know what you think.

Where?

I am already wondering where my office will be.  Should I stay in Columbia county, or should I be closer to home and have a West Augusta office?  The truth is, it shouldn't matter as much to my patients where I am physically located, as I am trying to keep them all out of the office.  Because I am wanting to go with the subscription model, I have no motivation to bring people in to be seen, so I will be trying to make the location of the office totally unimportant. One of the main things I want is to be unique.  This practice will be unlike any others in the CSRA, so I want the whole experience to be unlike normal doctors' offices.  What does that mean?  I am happy to hear suggestions.