If you were asked to list a few holistic healthcare hotspots, Ft. Wayne, Indiana probably wouldn't be at the top of your mind. Yet over the last 4 years, Jeff Gladd, MD, has built a thriving integrative family practice there—one that redefines what's possible in the trenches of today's healthcare.
Dr. Gladd's success proves not only that integrative medicine can fly in "small town America," but that it is still possible for a young physician to create an independent practice, even in a dire economy.
A graduate of the University of Arizona's Fellowship in Integrative Medicine, Dr. Gladd is one of a new generation of tech-enabled, holistic physicians establishing a new model of private practice—a movement that flies in the face of trends forcing many doctors into salaried jobs as custodians in huge networks of "care."
GladdMD, as he named his practice, is a consultative, direct-pay model in which Dr. Gladd is supported by two part-time nurse practitioners, a dietitian, a client concierge, and a robust, highly flexible IT platform called Hello Health.
He got the practice up and running for under $30,000, never even touching the $50,000 line of credit he'd taken out. After four years, GladdMD is scrambling to keep up with patient demand.
Finding the "Right" Triangle
"You need to find a way to work within the right triangle---the triangle of mind-body-spirit---not the triangle of provider-patient-insurance company," Dr. Gladd said at Holistic Primary Care's annual Heal Thy Practice conference last fall. Everything that happens at GladdMD is guided by a few core values: to bring health to healthcare; to promote health in every interaction; to use technology as a medium of care.
In an era when med schools no longer teach students that private practice is even an option, it's no small thing for a young doctor with a growing family to build an independent practice. Dr. Gladd decided to go that route after he got a taste of insurance-dominated, institution-driven care.
It was his own health challenges—weight gain, insomnia, panic attacks—that led him to discover the transformative power of a whole food diet. By changing his own lifestyle, he lost 50 pounds and was able to get off anxiety meds. His interest in natural medicine led him to the Arizona program. On completing the fellowship, he tried to implement an integrative model in a conventional setting.
It didn't work.
"I had built a good family practice, but I was seeing 30 people a day. After I got interested in nutrition and realized what health was all about, I really couldn't go back to the 7-minute visits and quick prescriptions."
He then tried to start an integrative practice with a local hospital. "We had some success, but the business model was crumbling. We were trying to bill insurance for these hour-long visits." The institution-based practice was bogged down by red tape and made all the worse by "Windows 95-era technology," and a lack of administrative vision about health-centered healthcare.
Nutrition is Center Stage
"Ultimately, I got to the point where I wanted to be in charge, on my own terms. I wanted to be able to practice what I preach, to spend more time with patients, and also spend more time with my family—no call, no weekends, no rounds."
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