Dr. Mark O. Carlson of Siouxland Adult Medicine in Sioux City is practicing medicine the way he has always wanted that allows him to spend more time with his patients and provide more personalized healthcare.
Carlson, a board-certified internal medicine specialist, is one of a rising number of doctors who have switched from traditional private practice to concierge medicine, a model that charges patients an annual fee in return for more personalized time and attention.
Personalized healthcare is practiced by 5,000 physicians nationwide, mainly on the East and West coasts, and in larger cities. Concierge medicine was started in the 1990s in Seattle as an innovative way to deal with rising costs and shrinking insurance reimbursements, allowing physicians to limit their number of patients, while being reimbursed higher on the fewer patients they serve.
Carlson switched to concierge medicine last fall after working a grueling schedule for many years. He was medical director of the Hospitalist program that he started in 2006 at St. Luke's Regional Medical Center - now UnityPoint Health-St. Luke's, where he was on call 80 to 140 hours a week. In 2008, Carlson opened his own medical practice, Siouxland Adult Medicine clinic, in Physician Center One, where he was working on alternating weeks. He cared for a large internal medicine population, and performed executive physicals for two large companies and the Police Department.
"I could not sustain that workload as a physician," said Carlson. "My passion has always been preventative healthcare. I decided if I was going to do the best job, I needed more time to address all of a patient's problems at any given visit and afford more access to me in emergency situations."
Carlson is one of the first to open a preventative healthcare clinic in the Midwest. For an annual fee of $1,500, Carlson's patients can have access to him 24/7.
"I give my patients access to me after hours by cellphone and by email. Generally, patients don't abuse it. If something is going wrong, I would rather hear about it sooner than later," he said.
For Carlson, the decision to switch to concierge medicine was based on his desire to make his own decisions on what constitutes quality care.
"I like to spend more time with patients. In the real world of healthcare delivery, doctors are seeing more patients and spending less and less time with them. On average, patients get 5-8 minutes of face time with their doctor in most clinics. That number is going to get worse," he said. "Our focus at Siouxland Adult Medicine is on providing the highest quality of care, access, patient satisfaction and excellent outcomes."
Carlson's patients receive round-the-clock access to him, on-time half-hour appointments the same day or next, and a two-hour block of his time for an annual physical, which includes aggressive prevention and screening for conditions such as diabetes, stroke and heart disease that lead to mortality and pre-mortality. Longer visits enable Carlson to provide comprehensive whole-person care, rather than the more typical treatment of one issue per visit.
"If you manage those problems you're less likely to have major events," said Carlson, who has privileges at both hospitals in Sioux City. "Patients who are under personalized care programs experience 65 percent fewer hospitalizations than like age counterparts. You add cancer prevention, and patients have a maximum quality of life. An 85-year-old should be able to mow his lawn, drive a car, and make cookies, and do the normal things that normal people do rather than be in a nursing home."
Patients receive their comprehensive exams and physicals in a remodeled, state-of-the-art facility at 1605 Douglas St. It is equipped to provide bone density testing for osteoporosis, skin cancer diagnosis and treatment, skin care procedures such as chemical peels for younger looking skin, fall and fracture prevention, balance assessments for inner ear and balance problems, as well as advanced lipid and genetic testing, allergy testing, and advanced metabolic testing for risk detection and prevention. Most of the lab work is performed on site in the service laboratory.
The remodeled clinic, which opened in September 2012, also features treadmill electrochardiograms and pulmonary function testing to assess heart and lung function.
If any abnormalities are detected from the testing, Carlson works with patients to identify any underlying factors in their lifestyle that may lead to a chronic condition and develop a customized wellness program that may reduce symptoms, improve quality of life, and may help avert diseases such as stroke, diabetes and heart disease.
Sixty percent of early deaths are a result of behaviors and/or chronic conditions that are preventable. If not addressed properly by your physician, chronic conditions can prove to be both difficult and costly to treat.
Carlson's healthcare management of patients has yielded results. One patient he has managed for 20 years is 100 years old and is still living on his farm. He and his wife recently celebrated their 80th wedding anniversary. Carlson has had many successes like these over the years and acknowledges every birthday with a card.
"Some of my patients get grief from their coffee sipping buddies for paying a fee for the concierge program, but most of them are not listening to those guys and are happy with the care they're getting. They're getting better healthcare. As the number of physicians shrinks, it's going to get harder and harder to get access to an internal medicine doctor, which I am. The number of clinic-based internal medicine doctors is rapidly decreasing. They're mainly becoming hospital-based doctors."
Patients who decide not to participate in the concierge program with Carlson have access to Dr. Garry Clark, D.O., and Molly Schooley, PA-C, for their healthcare under Carlson's supervision as medical director.
"Everybody knows everyone in the clinic," he said. "Everyone knows the patients."
Carlson said his concierge medicine practice is gaining traction in the community.
"It's good for patients and good for the community to have an option like this. The more options, the better. I see myself as part of the solution. Through the concierge program, I am able to help people who seek and want my help the most," he said. "I am happy to provide the high quality care I want to provide."
For more information about the concierge program at Siouxland Adult Medicine, call (712) 234-1005.