Radical Access is an extension of the concept of “Open Access Appointments.” This idea is based on the simple belief that we should do all of “today’s work today”. The wait time for a routine appointment is simply today. The difference we created at Care Practice is by placing an evening doctor on call that is available for house calls or meeting people in the office after hours for a moderate additional charge we have added “tonight’s work tonight”.
Such access is foreign to most primary care offices and is something Dr. Blackledge believed was key to making Care Practice what he calls, “the practice of least resistance.” This new strategy of physician accessibility is one of the key elements that has spurred Care Practice’s phenomenal growth over its first year of operations.
Better access to care results in a high level of doctor satisfaction because frustrated patients are no longer a daily experience. Daily appointment availability has increased the likelihood that patients will see their own personal physicians.
This results in greater efficiency, improved
continuity of care, better health, a greater sense of control for patients, and improved patient satisfaction. Costly missed appointments that plague many primary care offices that schedule visits far in advance are greatly reduced. We don’t have to hold appointments in anticipation of same-day needs, so we gain capacity for today’s work. Our overhead is reduced because staff does not have to waste time on a continuous backlog of patients and follow up from missed appointments.
Our unprecedented evening access reduces health care costs by reducing unneeded tests and labs because we know patients have access to one of our doctors almost 24 hours a day. It reduces liability because we can manage unforeseen complications around the clock through email and the telephone.
This access reduces unneeded emergency room visits and additional office visits to doctors who may not be aware of the previous patient history. We do not finish with the patient when they walk out the door we take responsibility for managing their illness even after they have left the clinic.
Contrary to what some may think, we have found that patient demand for appointments and after hour phone calls actually decreases because they know they have access to a doctor and can be seen almost anytime if necessary. The only level of access that we discourage is walk-in visits. We do this because we want people to wait as little as possible and feel that the walk in model doesn’t lend itself to the level of service and the flexibility we strive for at Care Practice under the Radical Access concept.
At the beginning of Care Practice Dr. Blackledge’s goal was to perform a level of service beyond anyone else at the lowest prices in the market. To succeed at this goal Care Practice would have to reorganize the way primary care was delivered and Radical Access was the approach that we came up with. To this date we feel we have been very successful with exceeding expectations and doing so at strikingly low prices. We do this by creating capacity through our flexibility that is often based on the single unit of the primary care doctor who is capable of doing everything in the home or office by him or herself.
Our only concern at this point is that we have done such a good job that we may have set expectations too high. This new level of availability is not based on a concierge model where you pay extra fees to have a doctor at your disposal 24/7. What we have done is place a doctor in the neighborhood who is available to see patients and will try and accommodate people as needed. When we say the office is staffed 365 days a year with an on call doctor that doesn’t mean we have staff sitting in the office waiting for your phone calls on Christmas day or at 4AM.
What that means is if you call the office when we are not in and press one for the on call doctor then the call will be transferred to the doctor’s cellphone directly. At 4AM you will be certainly reaching a doctor who is sleeping, but who is ready to serve you if the circumstances dictate that you need an urgent medical attention. Think of an old movie where someone falls off a ladder and someone yells go get Doc Flanders from the Mitchell place. This is a new version of that same old fashion doctor in the town, but in this case it is a doctor in the neighborhood using technology to better connect with patients.
