There is a sort of culture change when healthcare consumers choose practitioners who work outside the insurance model, as opposed to those within the conventional medical model. While I believe most our clients choose our practice because they “want something different” or they “want to be an active participant in their healthcare,” I am not sure they always understand this transition requires a shift in their mindset.
We don’t accept patients.
As a young nurse starting to recognize how the medical system was railroading women in childbirth, I started to question the relationship between healthcare providers and consumers. It seemed we were too often forgetting these women were adults, with their own thoughts and opinions, their own rights as human beings. I understood the culture in the emergency room when patients were brought in by ambulance and were dependent upon our every skill to save their lives, without question trusting our management. Childbirth however, was a different scenario. Women weren’t ill. They weren’t incapable of making decisions. In fact, many came in quite educated and knew what they wanted. Why were we so challenged by this? I think because we wanted them to be patients, and didn’t recognize them as clients.
As a nursing instructor I was very clear that while in their maternity rotation, students were to avoid using the term patient, and rather refer to women as clients. I do believe this helped them approach their daily assignments with a different mindset, one that shared responsibility in decision-making and one that considered their client’s points of view. Most importantly, I hoped they recognized that this experience was the client’s and she was the expert in her own individual care.
As a midwife, not once have I slipped and used the term patient, nor have my staff as I am aware. In fact, those that fail to utilize this term clearly indicate they don’t have the right mindset for our practice. As we’ve expanded our services to functional medicine and have started implementing programs of care, we are also referring to our clients as members. This is important because it creates a community of like-minded individuals with a similar goal. It also eliminates the fee-for-service mindset.
Ironically, we still have clients who prefer to be patients. They may not recognize this, and some would argue with me, but we find that there are those that want something different, but they really aren’t ready to change their mindset. They still want us to make their decisions. They want a quick fix. They want us to manage all their insurance claims. They don’t want to invest time, travel, or any expense to invest in their health. They want to be dependent entirely on their practitioner, and entirely on their insurance company to cover the fees.
Visit our functional medicine page for more information on insurance companies and functional medicine. We choose to work outside the health insurance model so we can work together to determine what is best for your individual needs, rather than being director by a third party payer who is responsible first to their own shareholders.
Our system isn’t set up for patients. We don’t allow for walk-ins. We don’t have a wall with a sliding window to converse through that separate us from you. We won’t tell you what to think. We won’t just write you a prescription. We won’t stand during your visit as you share a few thoughts and we give a few instructions before we’re out the door. We won’t email you clinical advice. We do not care for clients on an assembly line, allowing only six minute visits.
Our model is different, and here’s why: WE ARE DIFFERENT. We value education. We value one-one-one care. We want to give you our undivided attention. We want to hear you and we want to create individual plans of care for each client. We value informed consent. We believe you are the expert in your individual plan of care.
If you are eager to be our client, consider a mindset change.
If we are extending this commitment to you and you get it, and you want to be our client, Yeah! The truth is midwives have the WOW factor. We spend an incredible amount of time with our clients, and really invest in them. I can’t even count the number of times we’ve heard a nurse or physician say, “I’ve never seen a practitioner spend so much time with a client, helping them breastfeed in the NICU, visiting their home, or coming with them to their procedure.” However, keep in mind, we extend this same dedication to all our clients. Investing in clients is demanding. It is time intensive. We spend hours teaching and hours upon hours in consults or laboring with women. We work all hours of the day and night, and all days of the week, including holidays. When we’re serving a client, we do not simultaneously review labs and return phone calls for others. You have our undivided attention.
As a client, you have to work, invest, and engage. You have to follow through with the plan and communicate your needs so we can adjust accordingly. You will have to return for follow-up visits and trust that long term changes require patience, perseverance, and persistence. You will also have to recognize that we will commit to spending hours, or even days, with clients – the same client without ceasing. While it may make us somewhat distracted from the routine of the daily clinic, remember, we will dedicate the same time to you – which is why you chose us in the first place. We don’t have a staff of twenty to delegate all our clinical care, because our clinicians want to be involved in every aspect of your care. We value you. We have a partnership.
We don’t blame you when you have unrealistic expectations. Our culture has trained us to be patients. We have been trained to be demanding. We’ve been trained to demand being put first or our needs will go ignored. The loudest squeaky wheel gets oil. The biggest bully wins the greatest attention. However, this isn’t our culture. We are different. We want to educate you in how to be your best advocate. We want you to see yourself as a healthcare consumer. We want to be your partner in healthcare. We have high standards of clinical excellence, and we have standards for how we want to be treated as well. If you’re seeking a partnership and are willing to invest in that, I can’t imagine you’ll find anyone more committed to your success than our clinicians.