What Is Membership?
Membership is the financial model we have chosen that enables us to provide you the best possible medical care. In this model you become a member of our team, not just a consumer of services. Most clinicians use a fee for service model in which there is a definable charge for each and every service provided. We believe this older model puts barriers in the delivery of care.
Why Should I Become a Member?
This is a great question that we have been asked many times and it deserves an answer. Understanding how we arrived at our membership model requires understanding our current episodic health care model and its deficiencies. Then we need to discuss how medicine has changed in the last 20 years and how we are addressing this through our program.
Understanding the Pay-For-Service Model
Our current health care model is based on acute illness and episodic care that dates to the mid 20th century. At that time, a person would get pneumonia or have an acute surgical emergency like an abscess or appendicitis. These singular episodes would be limited acute issues that would be resolved after an intervention. At that time we did not understand how chronic disease developed and did not have treatments to address chronic illness. We did not even understand preventative health and health maintenance. However, as our medical and scientific understanding has advanced, our medical model to deliver care has not. We are using the same acute care model to deliver health care that our grandparents used. Today medical and technical advances require a more in-depth approach to health care that cannot be addressed in a single 10–15 minute appointment. The Functional Medicine approach recognizes the interconnectedness of, well, everything and this requires extended patient visits and time to digest a person’s list of issues and then research that individual’s condition and state of wellness. In addition, Functional Medicine & Integrative Medicine require several years of additional training and education on top of the physicians initial training.
As our medical and scientific understanding has advanced, our medical model to deliver care has not.
Keeping Pace With Advancing Medicine
Medicine is advancing too quickly to be practically used in a pay-for-service model of care. Approximately half of our current medical knowledge becomes obsolete every five years; and yet on average, it takes 17-20 years for new discoveries to become the standard-of-care. The standard pay-for-service model of care does not take any of the newest research into consideration when treating people. Only after the information has become accepted across all domains, studied in Randomized Double-Blind Placebo Controlled Trials (RTCs) and approved at the University level does the new knowledge pass on to patients. This ought not to be. The practice of medicine is called practice for a reason. For example, as of the writing of this (11/16), Chronic Lyme Disease (or Post Lyme Syndrome or Chronic Inflammatory Response Syndrome or whatever you would like to call it depending of what literature you’ve read) is not recognized by the Infectious Disease Society of America and is not taught in medical schools. This same year one of our local Infectious Disease Physicians told me there was no such thing as Chronic Lyme. Yet the International Lyme and Associated Disease Society has annual international conferences attended by hundreds of physicians and any Google Scholar search will find hundreds of research articles on the topic. Multiple this one example by all the advances we are seeing in genetics, metabolism, proteomics, epigenetics, microbiomics, viromics, ect … and it is easy to see that our current system is woefully unprepared to take these complex advances and apply them in a 15 minute time slot to chronically ill patients or patients who want to maximize their health. Some have coined the phrase Super Generalist to describe this scope of care.
Keeping Pace With Escalating Costs Within a Fractured System
As medicine has become more complex, the costs of delivering care have skyrocketed —necessitating a health care delivery system outside of the current model. Suffice it to say that the standard financial model is inadequate and unless a model outside of the insurance-driven system is implemented, access to care will be greatly restricted in the future. Finally, our current model of care is critically fractionated into multiple specialties and subspecialties. This fractionation leads to missed diagnoses and poor outcomes — an issue that has risen to the federal level: the Centers for Medicare and Medicaid Services are trying to figure out at a national level how to address this fractured health care system. Functional Medicine has introduced the generation of the Super Generalist Physician —a doctor who has a wide range of training and expertise and the time to apply their expertise to their chronically ill patients and those wishing the most advanced preventative care.
Our answer to the above concerns and more is a membership model to access Functional and Integrative Medicine. Our membership model allows us to use insurance to pay for necessary testing while providing our patients the extended time and care they need and deserve. We recognize some will prefer to stick with only the care reimbursed by their health insurance. Yet we do not want that to limit our ability to provide the most up-to-date and advanced care to those who need it or to those who want to use the latest screening and preventative care and wellness evaluations to help them maintain their health.
What Does Your Membership Cover?
Functional Medicine is an evidence based systems biology approach to human health, functioning and disease. Integrative Medicine seeks to unite different medical & therapeutic modalities into a coherent treatment plan. This is a time-intensive process that requires advanced testing and evaluations not presently covered by insurance plans.
At RIFM we provide all your standard care through insurance. All ‘above & beyond’ care is then covered through your membership agreement.