Recently, Insidesurgery had a chance to sit down and talk with Dr. Chiaramonte, who left the traditional practice of family medicine and opened a patient health advocacy practice called Insight Medical.
How long have you been in business with Insight Medical?
The seeds for Insight were planted while I was still in residency and have been taking shape throughout my career. But I officially opened my doors in September 2006.
Do you have a traditional office practice?
My current practice, as a Private Medical Care Advisor, is quite unique. Although I practiced traditional Family Medicine for years, my practice is now dedicated exclusively to helping people navigate serious illness.
My services are highly individualized, based on the patientsâ€™ needs and includes things like finding expert doctors, helping with complex medical decisions, and investigating the newest treatment options.
I also do things like educate family members about their loved oneâ€™s illness and I help patients cope with the challenges of their illness.
In your Insight Roadmap plan for $500 you offer a Personalized Health Portfolio, an Insight Action Plan, and a Portfolio conference. Can you explain what each of these are?
The Insight Roadmap empowers patients to effectively access the best possible healthcare. In this two hour assessment I explore their concerns, identify their educational and referral needs, and take a complete medical history.
After the meeting I create a Personalized Health Portfolio. This Portfolio includes an organized compilation of the patientâ€™s medical records, medical history, and relevant reference material. It is designed to be used by the patient to facilitate communication with their doctors and to foster their own understanding of their condition.
Included in the Personalized Health Portfolio is an Insight Action Plan, which outlines an assessment and management plan for each of the patientâ€™s significant medical issues. At the Portfolio Conference I explain the Action Plan to the patient and present them with their Portfolio.
What one single service do you offer patients that is most valuable to them?
The most important thing that I offer to patients is empowerment. By identifying and addressing the areas in which they need guidance (finding the right doctor, making a medical decision, thoroughly understanding their treatment options, etc.),
I help patients gain a sense of control over their health. My extensive office visits, usually 2 hours in length, allow me to identify many areas in which patients are struggling, and to provide specific, targeted interventions. A patient who comes to me feeling frustrated and overwhelmed is often transformed into one who feels hopeful and empowered.
Do you go on patient office visits? Chemotherapy treatments? Inpatient visits?
Absolutely. I am happy to accompany patients on doctor visits, to chemotherapy appointments, for tests or procedures, or while they are in the hospital. I can help people understand the information provided by their doctors, help them to effectively communicate their needs, and help them to avoid medical errors.
Do you advise on patient situations other than chemotherapy?
Yes, I can help people with many different illnesses â€“ not just cancer. I have had patients with heart disease, kidney disease, diabetes, multiple sclerosis, chronic diarrhea, and other acute and chronic illnesses.
Basically, anyone who is struggling with the medical system or with an acute or chronic serious illness could probably benefit from my services.
Do you help people with accessing the mental health system?
Sure. Our minds and our bodies are intimately connected, and illness affects them both. Many patients with serious illnesses suffer from depression or anxiety and I have several excellent mental health practitioners to whom I refer. In addition, I find that complementary practitioners, such as acupuncturists, massage therapists, and even hypnotherapists, can help some patients to deal with the stress and symptoms of illness.
Why did you switch from traditional practice to health advocacy?
Within the traditional medical system I couldnâ€™t give the kind of detailed, individualized care that I think is so necessary for people who are coping with serious illness. It was simply a matter of time â€“ I used to see 25-30 patients a day, giving each patient only 15-20 minutes.
Now my visits are usually 2 hours long. With that amount of time I can address many issues that patients might not bring up with a traditional doctor, and I can provide much more individualized support.
Some cynics will say you are offering what your patientsâ€™ doctors should be offering anyway. How do you respond to that?
Iâ€™m sure that many doctors wish that they could spend as much time caring for their patients as I can with mine. Our medical system has changed over the years and doctors now must see many more patients per day than our predecessors did. Yet, there is more to know than ever before and seemingly endless insurance documentation requirements.
Modern doctors are stretched to the limit and many of them simply arenâ€™t able to offer the kinds of services that I provide. I might spend four or five hours researching and writing a comparative assessment of two treatment options. How could a traditional doctor who sees 20-30 patients every day possibly find time to do that?
Do you discount your fees based on the patient’s ability to pay?
I understand the financial pressures that complicate many peopleâ€™s health issues, and I work with my patients to find the level of service that they are most comfortable with. I also offer regular pro bono services to a limited number of people who are completely unable to afford my services.
Do you take pediatric patients?
Absolutely. As a Board Certified Family Physician I am trained to care for children and have done so throughout my career. In addition, I have two children, one of whom has several significant health issues. I understand the issues common to children with illness both from the perspective of a physician and from the perspective of a mother.
How do you get patients?
Word of mouth referrals and meeting people via speaking engagements are the primary sources of my patients, although some people do find me on the internet. Because of the time intensive attention that each patient receives, I can only accommodate a limited number of patients per week.
Do you help people straighten out insurance problems?
While this is not the focus of my service nor my particular area of expertise, I can offer some assistance with insurance issues. Specifically, if an insurance company is declining payment for a medically necessary service, I can write a letter detailing the medical facts of the case in an effort to reverse their decision.
What has been the reaction from treating physicians?
It varies. Some physicians are initially wary, but once they see that their patients have become more involved with their health care and more compliant with their treatments after working with me, these physicians often become more accepting. Most ultimately realize that we both have the same goal â€“ a healthy and satisfied patient.
Are there lots of other companies/groups out there doing what you are doing?
There are actually very few. And many of the ones that do exist use nurses or social workers to provide much of the service, rather than physicians.
Do you offer advice on alternative therapies or alternative practitioners?
Absolutely. Many people who find their way to me are interested in complementary therapies. I not only provide information on which type of complementary therapy might be helpful, but I also provide personal referrals to excellent local practitioners.
I regularly meet with local complementary medicine practitioners, tour their offices, and explore their treatment philosophies so that I can provide my patients with individualized, meaningful referrals.
Copyright 2007 InsideSurgery.com