Philosophy
Doctor On Call was established by Dr. John R. Vigil as a much needed alternative and more humanistic model of providing medical care than that traditionally provided in Hospitals, Doctor's offices, Urgent Care Centers, and ERs today. In his experience in both a traditional office practice and in the ER, Dr. Vigil has observed that, especially in the ER setting, because of several factors including time constraints, patient and physician frustration, and the sterile and impersonal--and sometimes hostile-- environment of the ER, it is extremely difficult to establish a true and mutually satisfying doctor-patient relationship which is the cornerstone of traditional medical care and vitally important to therapeutic success.
He has also observed that many visits to the ER--if not most-- are of a non-critical nature which could easily be taken care of at much less expense, in a less chaotic and stressful setting, and with much less waiting and frustration for the patient and family.
Finally, Dr. Vigil has made the observation and is of the opinion that many--if not most--physicians, including himself, have come to rely too much on the 'latest and greatest' in medical technology and scientific advances in the care of their patients while abandoning or at least placing significantly less emphasis on the more humanistic (and perhaps less glamorous?) "art" of medicine which has been 'tried and tested' by physcians for hundreds of years and which involves the thoughtful and careful examination of the patient and investigation of his complaints (by the physcian and NOT the latest multi-modality scanner!) while actively listening to the patient, physically touching and comforting the patient, and showing true care and concern for the patient. In short, with the rapid and recent--and often bewildering-- advances in medical science and technology, we have come to view and treat the sick and unfortunate patient as a disease process to "throw our formidable armamentarium at" rather than as a fellow human being that is afflicted by and suffering from disease and who would benefit most from the sage application of both the "art" and the "science" of medicine.
It is interesting to note that just a few decades ago before the advent of antibiotics and newer technologies physicians were revered and respected despite the fact that they could offer little more in the treatment of disease than an empathetic ear, a diagnosis and prognosis, and a warm gentle caring touch while today we have the ability to treat and cure diseases in ways that were unimaginable just a few years ago and yet, we are viewed today by many as "a necessary evil" at best and at worst in "utter contempt" by some. Like it or not, we as physicians must quit assigning all of the blame to "greedy" lawyers and "big bully" insurance companies and assume at least some of the blame for the current state of affairs and for the dwindling esteem that we are held in by society in general and our patients in particular! And, should anyone, including lay person or professional colleague dispute these observations, they should make note of the fact that BILLIONS of dollars are spent every year on alternative health care while a very large percentage of our society seek consultation by alternative medical practitioners and if not convinced, they may also make note of the worsening medical malpractice crisis looming amongst us!
Another interesting--and no less critical-- observation is the fact that while all of us, including patients, providers, and payors, agree that quality is paramount in the delivery of health care, there are considerable differences between us as to what constitutes "quality"! A payor or insurance company often sees quality as a practice's or provider's ability to meet certain guidelines or benchmarks such as, screening for cancer, diabetes, or heart disease in a certain percentage of patients within the health plan while the physician or provider may see quality in terms of outcomes or providing the "latest and the greatest" advances available to their patients while the patient often defines quality care simply as provided by someone "who took the time to listen to me, to touch me, and to explain to me in my terms what is happening and why and who genuinely appeared to care for me".
Because of these observations and a general feeling of despair at the condition of medicine today as well as a gnawing feeling of unfullfillment and unenrichment within this once noble and honorable profession as it is practiced today, Dr. Vigil has made the commitment to try to change the status quo and to make a difference in the lives of his patients--and hopefully the lives of other patients by example-- by radically changing medical care delivery in his practice from a technology oriented and "provider friendly" system back to a "patient (and consumer) friendly system that emphasizes the "art" of medicine as practiced by our revered predecessors, and also emphasizes the dignity, comfort and convenience of the patient, AS WELL AS the "science and technology" of today's medicine.
With the inception of this novel practice model, Dr. Vigil envisions delivering direct patient care in an environment that is safe and familiar as well as convenient and comfortable to the patient whether at home or at the work place. This will have the advantage of sparing the patient and/or family considerable inconvenience as well as distress who are already distressed by illness or injury and who may also have added problems of limited mobility or difficulties securing transportation. Other advantages include no waiting time in a busy and impersonal waiting area, a prompt and enhanced face-to-face visit with the provider, a minimal amount of paperwork needed to complete by the patient including minimizing the need to recount his or her history to the provider only rather than a clerk, a triage nurse, a treatment nurse, the janitor, and finally the doctor! More importantly, the patient will be actually treated and instructed directly by the provider instead of a nurse as is often done in busy ERs. Finally, this will all be accomplished at considerably less cost to the patient or insurance company.
The ultimate results of these advantages should include the establishment of a mutually fullfilling and rewarding therapeutic relationship between doctor and patient, improved patient compliance, a decrease in the innapropriate utilization of the ER, significant cost savings, and most importantly, a healthy, happy, and satisfied patient!
Health Care Reform Blog
"There is an ancient admonishment to physicians to "heal thyself", perhaps it is time to reflect on what that means to us, not as individual physicians, but rather collectively as heirs and caretakers of a noble but ailing profession and perhaps a more contemporary charge for us should be-- "physician, heal thy profession".
