The holidays are a busy time for everyone. I know that no one reading this post needs a reminder that this is true! As a mother of three, board-certified Dermatologist, and small business owner I feel pulled in so many directions. Everyday, I come home from work surrounded by stuff. School papers, mail, incoming amazon boxes, books, laundry. I work tirelessly to clear things out, but the next day it all seems to magically reappear. It is exhausting.
With all of this physical congestion comes a great deal of mental overload. Some nights it feels like the total number of decisions I have to make never end. Many of them are of relatively small consequence… What gift and card expresses our gratitude best for our children’s teachers? What is the perfect gift to show our parents how much we love and appreciate them? Is it worth the extra $25 to have my address printed on the envelopes of all of these Christmas cards?
Last December, I was drowning in physical stuff and mental tasks. I thought to myself, maybe that Marie Kondo book that everyone has referenced over the years could offer some help. Nothing says “holiday spirit” quite like a book about ridding yourself of all your worldly possessions that do not bring you joy. I have to say the message of the book hit home. While I haven’t had the focus and willpower to follow her plan exactly, I have really taken a giant step forward in decluttering my life physically over the past month and it has been liberating.
As I was plugging away at the tidying task at hand, I thought to myself: This process is so much like what I have done to build my Dermatology Practice. Over a year ago, I made the bold decision to focus my career on my patients and end my long term relationship working for both Medicare and private insurance companies. I thought about all of the things I loved most about my job-- to support my patients not only in the treatment of their skin conditions, but also the emotional support and relationships we cultivate over time. Over the years those check-ups start to feel like coffee with a good friend. Most physicians go into medicine to help people. I don’t think that core value changes over time, but it becomes overwhelmed by all of the other stuff that comes with third party payers insertion into the middle of the physician-patient relationship. For me, it was the tireless hours spent providing extensive written documentation to justify the complex medical coding system, the prior authorizations, and the difficulty of fitting emergencies into my already swelling patient schedule. The culmination was when I realized the 4 AM note writing sessions were becoming a regular weekend occurrence. It was all too much. I had to make a change, and shifting my practice to a model where I work directly for my patients has been the blessing I was looking for.
With that in mind, I started to think about how this shift affects me when I am the patient. Decluttering this relationship is not only beneficial to the physician, it has huge benefits for the patient. One of the best things about this groundbreaking change is that I am available physically and emotionally. Patients know how to contact us directly via multiple modalities. When they call, an actual human being answers! Sometimes it’s even me! We can quickly bring patients in for emergencies both new and established. This increased availability not only decreases the stress regarding skin conditions but also has the ability to decrease time to diagnosis. Our patients can conveniently schedule appointments to work with their schedule whether it’s before work, Friday morning work in clinics, and in many instances the same day.
In addition to the increased availability, I have been able to provide more comprehensive care on a regular basis. Gone are the days where I have to explain why someone needs to book a separate visit to discuss hair loss or why Medicare won’t pay the $100 cost for me to freeze that spot and why you have to sign a form and pay upfront. If it is medically appropriate and it is a concern to you, we can address it. Now we have the ability to address all of your skin care needs with advanced planning.
Finally, one of the greatest rewards has been the ability to provide affordable care to the growing uninsured and underinsured population. This year we have provided so many skin checks, skin cancer removals, advanced acne, and biologic psoriasis treatments to those who previously thought they could not afford to take care of their skin condition. I have literally saved lives simply by providing a predictable pricing system for patients who are concerned they may have a melanoma (and did).
So my suggestion for you this year is to devote a little extra time to decluttering. Maybe you start with emptying out your closet so you can regularly see your favorite dress and that shirt that you forgot you love. Maybe you take it one step further and declutter the complex relationship between you, your insurance provider, and your Physician while you are at it. Either way it is effort well spent!