In today’s modern medicine model, practices and organizations have many levels of care and services. There is the front desk, office manager, nurses, techs, mid-levels, and the doctors. The patient is filtered through the system depending on algorithms, triage, and complexity, all before being seen by the clinician. Even clinician selection is based on the perceived level of care needed. Patients may see their surgeon for two total visits, one before and then one after surgery, then the care is switched to a midlevel to manage the remainder of care. This is rather different to older medicine where a doctor would come to the house to manage the entire course of treatment, or would be your attending in the hospital, seeing the patient’s entire course of treatment. With the onset of large groups, venture capital owned businesses, and hospital run clinics, medicine has become a system more than individualized care. Align Foot and Ankle is designed to have the entire course of treatment managed entirely by Dr. Barnett. Does it really matter how the clinical process works for a disease/condition? Or is the hands on, service-based model the best way to treat a patient? Dr. Barnett would love to share his insight on this issue.
Dr. Barnett gained his education at premier institutions including Temple University, Pennsylvania Hospital, Jefferson Hospital, and University of Louisville. He was trained by world renowned surgeons and clinicians that helped hone his skill in areas of internal medicine, surgery, and rehabilitation. He did rotations in each area of medicine, to allow a well-rounded clinician, only to find in practice that was not valued. Complexity with collections, staffing, and insurance “games” changed the way patients are treated.
Major corporate entities and large groups established how Dr. Barnett would practice, and he was told to simply “let other people handle the rest”. His company meetings were on how to make more money, not patient care. The model is high volume, high turnover, maximum allowed coding. The entity stressed the practitioners to maximize the billing, therefore a multitude of codes were more beneficial than actually finding the cure. The patient is viewed as a number, and that number has a monetary value as a unit of time and number of procedures. Because of this model, doctors tend to treat the symptoms not the underlying problem. Heel pain? Scheduled 3-4 visits for repeat cortisone shots to simply mask the pain. The never-ending office visits give little information about the cause of heel pain and does not create long term cure, leaving the patient with little hope. There are countless times Dr. Barnett can fix a problem in one or two visits that 10-15 visits with other providers could not do. It is not that Dr. Barnett is that much smarter, it’s that he takes that much more time to fully evaluate each symptom, use advanced diagnostic tools, and deep examination, to get to the root of the problem.
How successful a physician and practice is should be based on how they treat a patient, from start to finish, and ultimately curing people’s ailments. Dr. Barnett does not solely treat the symptom, but the whole patient. What line of work are you in? What kind of shoes do you wear? What is your routine and diet? What has failed in the past? How fast and aggressive does someone want to be cured? All these circumstances will affect what treatment to pick. Dr. Barnett prides himself in knowledge in many areas of foot care, from holistic/functional medicine to the most advanced modalities and surgical techniques. For example, Do you have gout? Does X-ray show excessive tophi or joint disease surgery is merited? Let’s look at a diet to reduce purines, consider oral allopurinol or probenecid, or go holistic with cranberry, Rhus tox, turmeric? Would joint injections of steroid, prp, stem cells help reverse to recurrence? Also, realigning the biomechanics with orthotics, muscle memory changes, and therapy can improve walking and thus reduce the stress load on a joint more susceptible to gout flare ups. Class IV lasers may be better than pills and cortisone shots.
Dr. Barnett has every option available in medicine, but it’s the relationships he develops that will help derive a cure. Every person is different and has different needs, therefore the systemic model of medicine really is not advantageous to patients.
Not only will a course of therapy be initially laid out, Dr. Barnett will oversee and guide the rehab every step of the way. Dr. Barnett gives out his cell phone to be available to his patients when they need him, and will oversee any ancillary treatment to ensure recovery happens as soon as possible. Dr. Barnett has consulted with many pro and amateur sports teams, and he provides the same advanced treatments and care given to professional athletes to every one of his patients, regardless of whether insurance will pay or not.
The bottom line, what Dr. Barnett chooses for his patient is a mutual decision between him and his patients. Evidence based medicine will lay out a timeline for recovery, but what someone chooses is based on their lifestyle and ability to rehab. Dr. Barnett hopes a shift will occur to where the doctor and their knowledge will drive the treatment process and overall experience, but until then he will be the change he hopes to see. The office is designed like a living room, and the care people get is as if Dr. Barnett’s mother was sitting in the exam chair. Align Foot and Ankle strives to provide the most advanced care in Florida while using concierge service, made affordable to all.
And stay tuned, that passion to deliver “quality care made affordable” will be exemplified with future Saturday clinic hours for those with financial hardships to provide free care, to keep Floridians moving without breaking the bank.