How to Fix Medicine: Our Strategy

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Have you heard? Medicine’s broken.

If you're not, the Modern Nose Clinic is here.

In this episode of Nuggets of Knowledge, we look at the three ways that the Modern Nose Clinic believes that medicine is broken and what we're gonna do about it. At the Modern Nose Clinic, our mantra is “Solving medicine one idea at a time.”

  • Accountability
  • Cost
  • Connection

Medicine’s broken, and there's no denying that. If anyone out there thinks the solution’s gonna come from the top down, don't hold your breath. It looks like it's not gonna be easy for anyone to fix. So does that mean we just give up? No way! At the Modern Nose Clinic, we've identified three areas that we believe account for the majority of the problems with medicine as we see it. We've got answers for each, and we want to discuss that today.


What the heck?! Well, accountability is really important. As a matter of fact, I would go on a limb and say it's perhaps the biggest problem facing medicine. Accountability on the provider’s part, and accountability on the patient’s part. Let me explain about the provider; if you're paid the same amount of money as a physician, whether you do a good job or not, whether you get the result you're looking for or not, over time you'll move towards seeing more patients rather than going for more quality.  This is not an easy one to get at, but what will happen over time is that you might say, “If I see 40 patients in a day, I'm paid twice as much as if I see 20 patients in a day.” So that's one problem with medicine is that there is no rewarding providers who are more successful and [have] happier patients more than providers who are less [successful and don’t have happier patients]. So accountability on the provider's part.

Also, accountability on our part. We need to make sure that we show up to work on time. We try to run our clinic on time. We try to be mindful of patients needs. And so on and so forth. So being highly accountable is one problem with medicine that we think we have some answers for. But you patients; you guys also, matter of fact, patients in general, and I'm a patient, patients may be the biggest problem in medicine because we're not accountable either. When the doctor says, “You know what? You really need to lose weight. If you lose weight, your diabetes will be better controlled, and your hypertension…” and so on and so forth. But we go home, and we fire up Netflix, and we grab that popcorn, and that ice cream, and that beer, and we say, “Yeah, we can worry about that later.” So really, the patients have to be accountable, too. They need to show up on time for their appointments; they need to be motivated and engaged. So a highly accountable provider and a highly accountable patient will lead to better healthcare outcomes.


Oh my gosh! If you go to the emergency room, you're lucky if you get a bill for $2,000. It can easily be much much worse, and I don't know how it ever got to this point. It has gotten out of control. Yeah, every year. What happens? Rates go up. Rates are going up continuously, and it is broken, and we are at a breaking point, right now. So cost is a major issue, and I've said this before. I've got a lot of friends who are doctors, and they say, “What are you doing, man. You're driving down your cost? Don't you need to, you know, charge as much as possible? Don't you need to negotiate up your rates every year?” But we feel differently, and I'd like to tell you it's because of a really great guy, and I'm a nice person for those of you who get to know me, but it's actually good business. If we're able to figure out how to get cost down so that when you come here, and you need to get a work-up done, you know you have the lowest-cost CT scan in the state. That's magic. That's just good business because people can make decisions without worrying about how much each step costs; and how do you do that? Well, you need to understand your cost completely, in a very granular way, and we do. When you understand your cost completely, you can get the cost down as low as possible with still preserving some income/some profit so that the business is viable. And I think that it takes a lot of effort to understand that it's an effort we think is worth taking, and that's how we're able to offer all of our services at such a low price and still feel like we can run an efficient business model. If you need a home sleep test, if you need a CT scan, if you need allergy testing, we're able to offer that at the least expensive price in the state, to our knowledge. And we review the results with you so we don't sacrifice quality. But perhaps, some of the best ways we save is that we've had zero patients going to the emergency room; we've had zero patients going to the hospital. We've had one patient go to the operating room because they requested to do that, but in general, we don't use these very expensive services at the Modern Nose Clinic. We're able to fix your problems right here in-clinic, and I think that really drives down the cost.


The final area where we think that medicine is broken is there has been a loss of connection. Patients don't feel connected, they don't feel heard, they don't feel understood, and therefore it's really difficult to form those kinds of relationships and the trust necessary to offer the best care possible. At the Modern Nose Clinic, we believe that we connect better. The most important part of connection is communication, and we endeavor to start your clinical experience earlier, and for those of you who have come through our clinic, you have experienced our intake process that you can do from the comfort of your own home on your laptop, or on your iPad, or on your cell phone. We also want to continue the education experience beyond your appointment. We want to blur the appointment experience so it begins earlier, and it continues later. We do so through a video library that we invest in every week; creating new content where you and your family can explore and learn more.

You know the funny thing is that life is short.

Crazy, as you get older, you start to understand that better, and when it's all done and said, it really are those friendships, those connections, and coming to work each day getting to work with a great team, as we have here; which is a lot of fun for us, to work together, and connecting with our patients. Really knowing who they are and being part of their lives. So, for instance, we do all of our procedures awake in-clinic. We invite friends and family members to observe, and during that time we really get to know each other. And I think that that connection’s been valuable to us here at the Modern Nose Clinic; we think it's also valuable to our patients.

If any of you happen to be a patient, feel free to comment on the YouTube channel. Please like and subscribe, and we'll try to keep bringing clinical content in the form of videos. This was an important one. May be boring, but important because we had talked about the three ways we think medicine’s broken and the three areas we’re really focusing on.

Dr. Douglas Skarada, medical director at the Modern Nose Clinic, signing out. We know your nose.