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An Open Letter To My Valued Patients



An Open Letter To  My Valued Patients. . .

I have become increasingly dismayed by dangerous changes to the delivery of medical care in America.  The government and insurance companies have exerted increasingly draconian control over medical decision-making.  Office visits are now too short to be safe or useful, and are unsatisfying to doctors and to their valued patients.  The computer has somehow become more important than the patient in the exam room.  Doctors are overwhelmed by unnecessary regulations and burdensome mandates that reduce the time we can spend in the care of patients.  I know many of you have shared in these frustrations as well.

I believe the doctor-patient relationship is sacred, and I am not willing to compromise the quality of care my patients deserve.  As such, I find I am no longer able to work in a system that erodes the doctor-patient bond and places the patient at unnecessary risk.  My trusted colleagues are responding to the same noxious pressures. Some of them have felt compelled to sell their respected practices to larger (typically less personable) health conglomerations.  Still others have retired much earlier than planned rather than compromise their medical integrity.  This hemorrhage of private practices contributes to an already disastrous primary care shortage.  Rather than sell my precious practice, lower my standard of care, or leave this noble profession, I have instead chosen a new model of patient care.

Like thousands of similarly concerned doctors nationwide, I am throwing off the mantle of interference by insurance companies and the government.  Instead I am entering into a contract directly with my cherished patients.  For a modest monthly fee (in most cases less than the cost of a cable bill or coffee habit) I will provide the type of medical care that used to be the norm and should be again!  I will be available to my patients in this new plan at all hours by private cell phone, text, email, video chat (if desired) and for same day/next day office visits.  Those office visits will also no longer be annoyingly time-limited, but will last until needs and care goals have been met.  After hours and weekend conversations and office visits will be included and available if needed.  In my office, insurance will no longer be used or needed.  The modest monthly membership fee will cover the care delivered in my office and you will not be charged at all for office visits, in-office procedures, most in-house labs, or available in-office testing (like EKG, lung testing, X-rays, etc).  My patients in this model will, of course, still need and use their health insurance for other care outside my clinic (like specialty referrals, imaging, ER visits, surgeries, etc) as per usual.  We can take medical care back to how it should be—comprehensive, caring, and centered around the patient.  In fact, in this model I am accountable only to my patient and never to their insurance company. 

To provide the type of care noted above, I will regrettably have to limit the size of my practice.  This is the very last thing I want to do in the face of a doctor shortage, and is the reason I have continued to toil for so many years in an increasingly toxic insurance model.  Limiting my practice size to take back the precious commodity of time spent with my patients was my only reasonable option.   My patients who know me well will be assured I did not make this necessary change lightly, or from a place of self-service or greed.  Indeed, I will likely have a much lower income in this new model than in the current system.  I will, however, be able to keep my integrity and independence, and once again give my patients the safe, comprehensive, and individualized care they so deserve.

With much appreciation and respect,


Cher Jacobsen MD



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