If you are an established patient, you probably know that I am a Stanford trained Emergency Medicine physician and have worked in private hospitals, academic centers, and Kaiser facilities over the past 12 years. I am also board-certified in Holistic/Integrative Medicine and have special interests in women's health, geriatrics and palliative care.
I know how difficult it can be to get high quality medical care quickly when you need it. Very few of us have primary care doctors who can be reached in a timely fashion. I frequently hear about poor pain management, wrong diagnoses, or long waits for minor problems, and in many cases, I could have easily helped you avoid the misery.
With this in mind, I am formalizing a service which I have been asked to provide for a long time. Without replacing your primary care doctor, I'd like to offer a back up option as your "doc in the pocket," optimizing your care in an emergency, dealing with simple problems efficiently, and managing complex problems more completely.
The concept has developed from our conversations over the years. When you were last in my procedure chair, we might have discussed your long wait in the ER for a simple bladder infection, the best medication for insomnia, which vaccinations to get for a trip to Africa, or difficulty handling a parent with early dementia. We talk about very personal issues and I get to know many of you really well. I have ordered labs, arranged cardiac stress tests, and given advice on parents' end of life care, but doing this during your 15 minute botox appointment is not ideal for either of us. I would like to formalize the process to assure your issue is properly addressed and followed up.
Further examples of the utility of this service:
You get sick while traveling- I communicate with health care personnel on your behalf, or even better, make sure you have the right meds with you to avoid that Mexican hospital altogether.
Your mom is very ill and it is not clear what options you have or what might be best for her. You might not connect with the hospitalist assigned to her. I could speak with you and/or with the hospitalist to assure the care she is receiving is in her best interest.
Your kid has yet another ear infection and it's midnight. You have to work tomorrow. All you need is a prescription but the advice nurse says go to the ER. I'm probably still up, finishing an ER shift myself. I get your text, call in the medication, and everyone sleeps (:
Existing patients who are relatively healthy would qualify for the service without an additional examination. Those of you with more complicated issues would need one intake examination at a cost of $150. Services could extend to your family after a meeting and physical exam- for healthy kids this would be $100, adults $200.
There is a one time set up charge of $100 to become a DocinthePocket patient and this will cover your first simple interaction or the first segment of any other interaction. All simple issues (<15 minutes with prescription as appropriate) will be $50. Segments are billed as follows: $50 per 15 minutes of the first hour, $50 per 20 minutes of the second hour, and $50 per 30 minutes of subsequent hours spent on the same issue. This means if you have a complicated issue like your parent's end of life care, the per hour cost comes down rapidly.
Though I can't be available 24/7, I would provide email or text support with appropriate prescriptions called in to your pharmacy within 12 hours, and phone support within 36 hours (usually much sooner than that, often immediate). Charges would be based on how much time is spent on the issue. I would bet that most problems could be managed for less than the average ER copay.
You can sign up for this service by completing and returning the intake and consent forms. You can print these and fax them back to me at (415) 520-0159. Records from your doc or any lab or radiology results could also be faxed to that number.
I am not interested in replacing the primary care doctor. In fact, having a primary care doctor is a requirement for participation. However, whereas you may get their advice nurse or an appointment in 3 weeks, you can contact me and save a lot of time and trouble.
I also provide a consultation service for elders who take many medications and would like to minimize the cost of the meds or even shorten their list. Click on "The Pill Cutter" link below or email me if interested.
I welcome your comments. Please use email: tammyfoster@pol.net
Thanks for being my patient!
