Focusing on the Patient, not the Middleman
Dec 30, 2014 06:40PM
● By Paula Frighetti
Dr. Garcia, Mr. An, Kayla Garcia
In July 2014, Cardiologist Dr. G. Mason Garcia and his wife, Kayla, a registered respiratory therapist, opened Tucson’s first direct pay cardiology practice, Sunrise Cardiology, PLC. In the more than 20 years that he has been practicing, Garcia had become frustrated with the increasing amount of paperwork and interference that comes between a physician and his patient from what he calls the “middleman in the exam room,” that requires “frivolous information” on insurance forms and dictates the length of an office visit. If a physician fails to fill out the forms to the exact specifications, they may not be reimbursed by the insurance company at the appropriate level.
Garcia believes that the health care in the United States is the best in the world, but there is no transparency about the cost. The same test that costs $300 in one hospital will unaccountably cost $900 in another hospital. Red tape and regulations beyond what is necessary to certify doctors are “choking the system,” says Garcia. He asks, “If I’m more in tune with providing information for the insurance company and the government, how much time does that leave for me to speak to the patient?”
Studies show that the more time a doctor spends with a patient, the better chronic disease is managed, and better management keeps patients out of the hospital. Garcia believes that a doctor needs more time to assess their patients than what is currently provided for by the current system. Extra time with a patient gives doctors a better understanding of their patient’s unique needs and can help avoid the unnecessary testing that comes with a “shotgun” approach.
Garcia believes that another reason we have lost track of the patient/doctor relationship is because, “Many physicians compartmentalize and look only at disease states, but when you look into it lifestyle, environmental issues and family issues are also involved. I see the whole system as not just the disease itself, but also what actually affects the patient socially, economically and even spiritually.” He firmly believes that lifestyle interventions are the most important factors in managing or preventing disease and that a whole systems approach to healthcare is very important, because, “If we just address the disease, we lose track of the patient.”
Restoring the patient/doctor relationship and giving patients another healthcare option is very important to Garcia, and his direct-pay system cuts out the middleman, removing the need for referrals and authorizations. This puts the patient in charge of their healthcare dollars. Sunrise Cardiology charges fees for services, but for a fixed price Garcia includes a specific number of tests and office visits per year, which often turns out to be much less than most people’s deductibles. Also, with the middleman out of the picture, his costs are lower because much of the paperwork is eliminated.
Garcia describes his practice as patient-centered and individualized. His vision for the practice is to “manage my patients in a way that allows them flexibility and options for their care. Getting back to the way healthcare is supposed to be.”
Garcia attended the University of Arizona and medical school at the Universidad Autonoma de Cu Juarez, where he honed his clinical assessment skills. He was taught to master the stethoscope and listen closely to the patient. Garcia trained as an intern and resident in internal medicine at Christ Hospital and Medical Center in Illinois, where he later became chief fellow in cardiology. He finished his requirements for interventional cardiology at Texas A&M and is board certified in both internal medicine and cardiovascular disease.
Sunrise Cardiology is located at 2380 N. Ferguson Ave. For appointments and more information, call 520-207-0962 or visit Sunrise-Cardiology.com.
Local contributor Paula Frighetti loves to learn, read and write about the environment, animals, people and sustainable communities. Connect at [email protected]. See ad page 9.