Hello, Joe. I encourage you and wish you great success with this addition to the traditional medical practices around the country in which we have to spend less time addressing more complex issues than has occurred in the past. This "older" style of practice often leads to unnecessary and costly referrals. In the long run, a practice such as you are developing, could save a lot of money and more importantly improve the health and quality of life of our patients.

For less affluent areas that Palm Springs, the government might supplement the patients' premium, when you show that this approach saves the Medicare program a lot of money.

Let me know how this goes. As you might remember, I was being approached by an organization in which the providers would make house calls to try to stabilize the patients and keep them in their own environments. However, as far as I know, this program didn't take off here in Arizona and the medical director was promoted to California, I believe to the San Diego area, if I remember right.

Good luck

Dick Elliott, MD

PS: I am working part-time in a nearby Same Day Care Clinic affiliated with Banner Arizona Medical Clinic. We have EHR which I can accsss at home, and for those patients in the Banner System, the records are available to the providers in the system to provide continuity and we fax our records to non-Banner providers to try also to maintain continuity of care. Not as ideal as a medical home concept, or such as system as you are developing, but seemingly working pretty well.

Greetings Joe, congratulations,and well deserved, I think you are an excellent match for this type of opportunity.

It would be worthwhile (and it could be a lot of fun as long as you have access to technology support) exploring some of the newer Web 2.0 communication options like oovoo, web cams etc., along with blogs and youtube to help your new practice create a growing online informational presence on behalf of your patients.

Also you might think about finding ways to cost-effectively assist your patients in developing habit energy changes to promote healthy lifestyles ( eg  weight loss, exercise, stress management, the usual suspects!).  You might even consider some group visits in this domain and bring in some crackerjack psychologists or other change experts.

David E. Bright, M.D.

Thank you for this article. I tried this concept and called it "SamsaRx". The reason I did this was because I could see NHS collapsing sand the service they offer is of substandard.
I felt people who need advice must get it from doctors. NHS has failed by making it difficult for patient especially parents get access to doctors. They introduced nurses, NHS direct and community clinics.
Unfortunately I could not sustain my clinic as I was not lucky like you to have received funding. I advertised and published posters in the town but there were not many takers. I felt people do not trust free or low price doctors service.
Now I am about to release a software that does my work. I have been a doctor for 25 years and have seen how commercialization has ruined the profession because the care was driven by cash. In NHS, I could offer the best treatment patient required. Unfortunately this has collapsed.
Your idea will work provided you get the support. Best Wishes.