You often hear a lot about how traditional healthcare is broken, and we need to fix it. But it’s not that healthcare is broken, it’s how we approach it. Right now, so much of healthcare is driven by insurance companies.
According to Healthinsurance.org, healthcare clinicians are paid by the amount of services they provide, essentially “rewarding [them] for volume and quantity of services provided, regardless of outcomes.” HealthAffairs research shows more than half of healthcare payments in the U.S. are based on this fee-for-service model.
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What this translates to for patients is reactive medicine with no focus on holistic wellness, preventive care or trying to improve long-term outcomes. We treat what’s on the surface without looking deeper into the root cause. In fact, a Commonwealth Fund study shows that despite the U.S. spending two to four times more on healthcare than most other high-income countries, it experiences the worst health outcomes overall of any high-income nation.
That’s not to say providers don’t care or want what’s best for our patients. We just aren’t given the time it takes to build rapport and ask the right questions within the fee-for-service model. That’s why I left traditional medicine.
Switch to outcomes-based care
I’ve been a physicians assistant for around 20 years, which has included stints in bariatric, general and trauma surgery, as well as occupational medicine and primary care in an urgent care setting. In urgent care, I would see 48 patients in a day. That’s just unhealthy and unsafe.
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A provider I worked with at the urgent care center moved over to an employer-sponsored healthcare model, and I saw a total transformation in him. He seemed happier and had a better work-life balance. He informed me when another position opened up within his company, and I took the role as a health center director for the City of Fort Collins, Colorado, in August 2021.
It’s been the best career change of my life and has revolutionized the overall joy that I experience from medicine. It made me return to the reason why I got into medicine—to help people. We focus more on prevention, which is what traditional models of healthcare have really lost.
Happier providers and healthier patients
Since we’re incentivized by outcomes rather than volume, we’re afforded more time with our patients to build rapport, ask the right questions and make connections. The average appointment time is 32 minutes, and I can spend even more time with any patient as needed. Patients often tell me, “Wow, I’ve never had a doctor spend this much time with me.”
That connection is key to having them succeed in improving their health. When you want to encourage a patient to make a lifestyle change or commit to taking medication, you need the time to educate them on why it’s necessary and how it will improve their life. It really works. Studies have shown value-based care improves outcomes and reduces costs and we are witnessing it as well.
Providers like me who work in an employer healthcare model can truly help people versus treating them reactively. In addition, we aren’t churning through dozens of patients a day—which is crucial considering half of all healthcare workers report being on the verge of burnout. Having more control over my schedule makes it easier to do my job and enjoy what I do. I really wish value-based healthcare was more readily available. As a society, we need to change our approach to medicine. I know I’ll never look back.
Photo: designer491, Getty Images
Steve Toth joined Marathon Health in 2021 and serves as full-time provider and clinical director at CityCare for the City of Fort Collins, Colorado. Steve earned his Master’s degree in the Physician Assistant program at the Arizona School of Health Sciences/ A.T. Still University in 2004. He’s also licensed in Basic and Advanced Cardiac Life Support, Advanced Wilderness Life Support and as a US DOT Medical Examiner. Steve has worked in urgent care, occupational health, bariatric medicine and surgery. He aims to provide the best care possible using today’s information and technology, while focusing on the human side of healthcare and treating the patient first.
Steve is also an active medical officer of the Colorado Air National Guard, and volunteers to support service men and women. Since joining Marathon Health, he has “rediscovered his why” – practicing medicine to help patients achieve optimal health.
