It’s a vicious cycle. As the patient load for primary care doctors grows, they are overburdened by cases and paperwork. They feel burnt out, and either reduce their hours or retire. New doctors concerned with work-life balance avoid primary care. With fewer providers, the workload increases on doctors who remain.
All the while, patients grow frustrated waiting days or weeks to see their primary care doctor, or don’t bother calling until their condition is an emergency.
It’s an inefficient, ineffective and expensive way to operate healthcare.
Delphi Enhanced Primary Care disrupts that cycle.
While many primary care doctors have panels of more than 2,000 patients, Delphi’s doctors are capped at about 600.
A monthly membership fee of $120 ensures that patients who need their doctor can see them for a same-day or next-day appointment. All members also have a direct line to their doctor, so they can call with questions and concerns, even outside of business hours.
“The demands of the volume, so many of us had to take care of too many patients with many issues, and not enough time to do the medicine part of the job,” says Dr. Jeffrey Calegari, DO, FACP. “We found ourselves working through lunches, staying late at night, coming early the next morning, just to kind of catch up and do things. It just became unsustainable.”
Now at Delphi, Calegari and Dr. Jennifer Fishbein, MD, see about 4 to 10 patients a day, instead of the 16 to 20 patients they used to. Patients get about an hour with them if needed — far above the national average of 17 minutes. They have time in their schedule to handle the necessary paperwork instead of squeezing it in off-hours
“We now have time to advocate for our patients, time to do the paperwork,” says Fishbein. “In addition to being able to get people in last minute if they need it, if someone comes in for their physical and, surprise, they have something else going on, we actually have the time to take care of it.”
A more manageable patient panel size allows doctors to have phone calls with patients personally instead of delegating that task to nurses.
“We’re able to handle a lot of things over the phone. Before we couldn’t make phone calls; there’s just no time in the day,” Fishbein says. Practices “wanted as many visits as possible, and so it was, ‘just book a visit,’ book a visit for whatever it is, and sometimes people didn’t really need to come in for it. We could’ve handled it over the phone if we had the time.”
While patients might worry about the affordability of paying an additional $120 a month for this model of primary care, Delphi President Andy Vailas says many patients could see a cost reduction for their healthcare overall.
When primary care practices are part of large systems, those doctors typically refer to specialists within the system, regardless of cost or quality. Patients may not pay those costs upfront but do ultimately pay through higher insurance premiums and co-pays.
“We steer towards high quality, low cost,” Vailas said of the independent practice. “Access and affordability is our mission.”
Savings can also come from having health concerns addressed early at the primary care level instead of delaying it until it’s an emergency.
“There were a lot of things in our former jobs where, we can’t see you. You have to go urgent care, or you have to go to the emergency room, because there’s just no availability to be seen,” Fishbein says. “That’s one of the great values of primary care, is having someone who knows you and knows your history.”
Calegari said at his former location that he was sending something like 20 people a week to urgent care because there was no availability.
Fishbein echoed that it got to the point where she wasn’t even getting calls from patients with immediate needs; she’d just receive follow-up notes from urgent care.
“What makes this practice ideal is we control the volume, and that just steers everything,” Calegari says. “If you can keep the panel size on the lower side, you can definitely manage the volume. Whereas if you are just open and you keep taking the patients, you just can’t keep up with it.”
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(603) 255–5579
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Delphi Enhanced Primary Care is a model that is more sustainable for physicians, which ultimately aims to reverse the downward spiral of quality options for patients.
“What I’m excited about is to hopefully it sparks a little rejuvenation for people who are interested in primary care,” Vailas says. “That they see an opportunity to get into a program like this, where they know that they’re not going to get crushed by seeing the number of patients.”
Having the availability to control patient panel size means that Delphi’s doctors have better work-life balance and can adjust their schedules to do things like visit their own dentist or doctors.
“Mental health is really, really important, both for patients and for physicians,” Fishbein says. “If you’re so burned out that you don’t have the mental space to give your all to your patients, then they’re not getting the care and attention that they need. You don’t have the energy to go above and beyond, like you would love to do for your patients. The burnout, it’s horrible for physicians, of course, but I think it ultimately affects patients in a very significant way.”
Delphi patients have access to physicians who can provide care immediately when it’s needed.
“The part that’s been so wonderful is patients are satisfied,” Fishbein says. “Patients are happy. We’re happy.”
By prioritizing sustainable workload for its doctors, Delphi offers patients a level of care that is personal and immediately accessible. To learn more about enrolling in one of its limited primary care spots, visit delphihc.com or contact care@delphillc.com or 603-255-5579.
