A Hands-On Approach to Concierge Medicine

At LRH’s Concierge Medicine office, Dr. Phung Phan brings a very personal touch to his family medicine practice. Dr. Phan uses osteopathic manipulative therapy – literally using his hands to diagnose and treat patients in his care. In this episode of Inside Scope, host Dr. Daniel Haight talks with Dr. Phan about osteopathic medicine and how the time his patients spend with him allows him to take a more holistic view of their health, including factors that affect them outside of immediate health concerns. He wants patients to be hands-on, too, actively participating in preventive care. 

Transcript

SPEAKER_02 0:02

Hello and welcome to the Inside Scope. Today, Concierge Medicine. When I think of the word concierge, I think of someone who is available to help my family and I in whatever we might need. And usually it's at a hotel, but now it's available in healthcare. So concierge medicine is our topic, and I want to welcome you to the Inside Scope. This is a podcast from Lakeland Regional Health where we share insights from experts providing award-winning care in our community. I'm Dr. Daniel Hay, Vice President of Community Health at LRH, and I also have the privilege of hosting this podcast. With us today, Dr. Fawn, who is a board-certified family medicine physician who practices at the Pablo Clinic on South Florida Avenue near the Southgate Mall. Dr. Fawn, welcome to the podcast. And I I know your your background, I think, makes this a very uh interesting topic, is that you're an osteopathic physician, and that training is unique and it provides some advantages. Tell me a little bit about osteopathic medicine. Uh you have DO after your name. So what what does that entail?

SPEAKER_00 1:14

Oh yes. Uh thank you for having me on the show. You're welcome. Um being osteopath, I'm trained to look at a patient holistically. Uh that means, you know, the person behind the medical diagnoses, and then what affects them in their lives, in their uh medical uh beyond the medicine part, right? And then uh also like their body as well. What's important in their body and what's out of place? You know, you will hear about manipulative therapy or osteopathic manipulation.

SPEAKER_02 1:42

Well, that's the hands-on. Uh because I think the physicians that do uh osteopathic medicine, a lot of it is hands-on. And that's to me always the most reassuring uh thing for a patient is uh when I listen to a patient's lungs, I often put one hand on their shoulder. And but you're being able to provide a lot of uh diagnostic and therapeutic relief?

SPEAKER_00 2:02

Yeah, absolutely. OMT is uh not just like how chiropractors do it, you know, with uh just cracking and things, but you know, OMT, uh not too I I love chiropractors, uh they're amazing. I they treat me and I prefer them to treat me. Um but uh with OMT I do a lot of diagnosing uh with my hands and then I apply my treatment and I always tell patients that that's just part of the treatment. Most of the treatment is actually on the patient. So I invite the patient into their uh care as well. So the exercises they do at home uh kind of builds their muscle around the the neutral um the the dysfunction that I made neutral now has to be held and supported by their muscles and ligaments, but they can only build those things if they do those exercises at home, for example.

SPEAKER_02 2:47

What does OMT stand for?

SPEAKER_00 2:48

Osteopathic manipulative therapy.

SPEAKER_02 2:50

Manipulative therapy. So that's the hands-on hands-on approach. Yeah, so I and I could see that even your background, I was curious on how it ties together that you uh were 11 years as an army physician. Yes. Uh were you stationed in the U.S.?

SPEAKER_00 3:05

I was uh my training was in Fort Bragg for three years uh in residency, one of the best family medicine residency there. I'm not biased or anything.

SPEAKER_02 3:13

Go army.

SPEAKER_00 3:14

Yeah, three three uh you know, three years there, and then I went through Fort Jackson uh where um I did three years as an officer in charge, basically a medical director uh there as well. So I was uh supervising physicians uh in urgent care, uh urgent care and um family medicine.

SPEAKER_02 3:30

So you were teaching, I I I think you and I were talking about how it's supervision is a lot of teaching.

SPEAKER_01 3:35

Yes.

SPEAKER_02 3:36

And when you're working with a patient in the family, it's a it's a lot of teaching. And I think that this concierge medicine concept to me means uh not just helping, but also spending the time. You know, is it is it something that seems more relaxed? It's a it's an interaction with a physician. Tell me more about the concierge kind of connection.

SPEAKER_00 3:57

Yeah, this concierge is a platform for me, it's quite a blessing. I get so much time to just talk with my patients that I always dreamed of having. But in the army, I know that you know they force a lot of metrics on us and time scheduling. Time scheduling, because you have to be efficient with taxpayer dollars, you can't be wasting it. So um I'm just trained to like move patients in and out of the clinic as best as I can while I'm like running a clinic.

SPEAKER_02 4:21

But now with concierge medicine, you have that efficiency with all the extra time to get to know people.

SPEAKER_00 4:26

That's right. It's an amazing uh place to be.

SPEAKER_02 4:29

Yeah, the c I think with the concierge medicine, it ties in that that extra get to know someone, what's matters most to them. To me, that's often left out of some medical interactions is to ask a person what's most important to you. And that's what the concierge medicine does is you're really getting to know the patient, their family.

SPEAKER_01 4:48

Right.

SPEAKER_02 4:49

Uh even if they're not the patients, the family members are critical in in the health and well-being of your patient.

SPEAKER_00 4:55

Right.

SPEAKER_02 4:55

Oh, excellent.

SPEAKER_00 4:56

Yeah, so not only like I have that time and efficiency that's already trained in me, but I I love my organization. LRH has been great. I always feel supported here. Um, even with like um, you know, small things that you don't even think about, like DAX, the AI tool. I get to be efficient because I don't even get to uh write my notes that much.

SPEAKER_02 5:14

I just like so the artificial intelligence helping. I I see uh and we were mentioning this before we started, was the as it as medicine is advancing, and concierge medicine is one of these newer advances, but you actually said it's actually going back in time, the the concierge concept. In what way is it going back in time in a good way?

SPEAKER_00 5:36

Yeah, as uh it's like going back in time but upgraded a little bit like that. Oh, it's a background.

SPEAKER_02 5:39

Better better back time.

SPEAKER_00 5:40

It's like a reformation kind of like, you know, like we you you're going back to the tradition of what medicine was supposed to be. Right.

SPEAKER_02 5:48

Getting to know your patient.

SPEAKER_00 5:49

Outside of the system, right? Outside of the extra systems, like the insurance and things.

SPEAKER_02 5:53

The paperwork, the right.

SPEAKER_00 5:55

Just truly the doctor and patient relationships, what I'm trying to get to. We have a system that works, uh works, but we have this now this concierge system that is going back to tradition, that is kind of upgraded in that um we have more time with the physician than patient interaction.

SPEAKER_02 6:12

Well, exactly. How much time? You know, so this concierge medicine concept is talked about, meaning more time with the physician and ease of access to getting in. And so tell me about the getting in, the scheduling part, and then the actual contact with you, the physician, and your team.

SPEAKER_00 6:29

Yeah, my team is what makes my practice so great. Like, you know, they're great. Right. I'm an okay doctor all by myself, but this with this team, uh, they just make me look so great. And um, the the front desk ladies, the two ladies I work with, they're always uh so quick to like answer the phone, and they're very creative with the schedule and the templating so that they can fit the patient in. Um, you know, priority is the patient, not me, right? So whatever they can do to my schedule to have that patient come and see me sooner, they do it.

SPEAKER_02 6:57

So they get the patient in sooner, the concierge aspect of it, and that's that service, like the customer. You know, this is you know, they're fitting into their schedule, not your schedule. That's right. And then the actual appointment and time with you. Uh what how what is the specific advantages that this offers?

SPEAKER_00 7:13

Aaron Powell The timing that um the time that's given to the patient is an hour, um, technically.

SPEAKER_02 7:19

Aaron Powell Especially for the first visit, because as we I've been teaching my uh medical students, you really want to get to know the patient in that first visit. And really, it takes an hour to go into the family history, the past medical history, not just the current medicines, but medicines that were tried in the past, allergies, other treatments. Other treatments, and then how are you doing today? And then that that key question we mentioned a minute ago. Now, what's most important to you? You know, that's the and then to me that really gives the patient time to ask questions. So is that the initial appointment is usually an an hour, and uh and then after that, is it sort of what's ever needed, or how does that work?

SPEAKER_00 7:58

Yes, so I get to see them an hour or more sometimes because uh currently as I'm starting my practice, it's not filled the schedule is not filled up all the way. So I do have I take that advantage and go over time.

SPEAKER_02 8:10

Yes.

SPEAKER_00 8:11

And I love it because I get to really deep dive, and my if my patients have the time, we just go for it.

SPEAKER_02 8:16

Oh, I love that you know I love that too, because I I used to like spending extra time with the patients, even talking, chit-chatting. But to me, it's the other things in life that often aren't discussed in the doctor's office that are really impacting people's lives. I'm hearing about an upcoming move or a change in a job or stresses at work, uh stresses within the family, and that helps me take care of the patient better. I remember that back in my clinic days.

SPEAKER_00 8:42

So I would find out details that I wouldn't have in a normal setting where I'm, you know, just I need to see the next patient. And I hate doing that, um, you know, in in uh especially when I was in the military.

SPEAKER_02 8:54

Yeah, and now it's much more relaxed.

SPEAKER_00 8:56

So yeah, this time I get to be just be me and just do what I need to do for the patient. And then finding out those little details, like, you know, um, those extra medications that they would have not mentioned, or those supplements that might be important in their care, or the lack of resources at home that that they didn't mention because they didn't have time, but now they have time.

SPEAKER_02 9:18

Yeah, the yeah, the time and in a in a relaxed setting, because I think you're you have a beautiful clinic that's set there in Pablo. Your staff is wonderful, they're a great team. Now you're also a family medicine physician. So I I love that idea of all ages in multiple areas. Um tell me what you feel is the most important thing about family medicine.

SPEAKER_00 9:36

For me, it's such a privilege to take care of the entire family unit, you know, the not just the patient, but um also drawing in the information from their family members that they invite into the clinic as well. But if I'm lucky enough, I get you know their family members in and now have the whole patient from the family unit, and I can take care of all together, and I have a better picture of the health uh that each member has uh based on their interaction with each other.

SPEAKER_02 10:02

Well that sounds like a like a you know big investment in time, and I think we're talking about concierge medicine, which is a new a new developing field in medicine. Yeah and concierge medicine and the idea of getting to know the patient and their family. How do you see that combining together?

SPEAKER_00 10:20

Just building that relationship like with my patient and then the family and then the community, it just makes me feel like a a more integrated and better um equipped physician to treat my patients.

SPEAKER_02 10:33

You know, my dad was a uh master sergeant and was stationed in Iceland, yeah, where he met my mother. Now, my mother's family had physicians and they were family doctors that would go out into the countryside, and I went with one of them in the in the rural, most rural part of Iceland, and we went from farm to farm.

SPEAKER_01 10:49

Right.

SPEAKER_02 10:50

But it was sitting at the dinner table or the you know the kitchen table, yeah, having a little coffee, talking about the the patient that's going to be seen, what's going on on the farm. To me, it was very relaxed, and you you gotta boy, what a trust trusting relationship to be invited into someone's home. And here I think it's it's the same. I think you're you're you're welcoming patients to come in and they are feeling that that kind of comfort. Do you see any uh technologies developing down the road like telemedicine? You mentioned artificial intelligence, which is sort of in the background helping and providing you know good factual confirmable information. But what about uh telemedicine or wearable devices, things that that may help the patient? Does this see any feature in that?

SPEAKER_00 11:36

I have a lot of thanks to give to my current manager. She does she goes and looks for these innovative products and then um recommends them to me. Like for home um for um sleep studies, we've looked at a few things.

SPEAKER_02 11:50

Yeah, so somebody who might be snoring at night or having high blood pressure, uh they may have risk factors for sleep apnea where you stop breathing while you're sleeping or you're snoring. So you're able to arrange uh the some kind of assessment that's not at the clinic but more at home at first. Right.

SPEAKER_00 12:07

Is that more of a screening test or yeah, just a screening test that we want to make sure like the patient can have the the most convenient things first?

SPEAKER_02 12:15

Yeah, which is easy to do at home. Right. It checks your oxygen, keeps an eye on your heart, and then the report is then s transmitted and then looked at, and and then assessed do you need to do more.

SPEAKER_00 12:26

Yeah, and other things like heart monitoring as well, you know, like um event monitors or halter monitors. We uh we look at other companies too, you know. So just uh so we have uh an option to give patients. But this this is why this concierge platform has made it s so easy for us to do be a little bit more innovative. And I and that's another thing that I really love about my current job and current position here.

SPEAKER_02 12:50

Yeah, and I think you you've and you've learned so much from your experience with the military as as with with my dad in the military, he retired at uh MACD Air Force Base where he did civil service. Yeah. One other experience I was going to ask you about is the is one of your hobbies. Uh you do wood wood carving?

SPEAKER_00 13:06

Uh not just general woodworking. I'll make furniture and or other pieces of tool handles and stuff. I'd love to make uh things from old into new. So I'll like find discarded wood and I'll just rejuvenate it or remake it into something else. Excellent.

SPEAKER_02 13:21

You know, that's what I I we're we have a number of physicians that that's how I feel when I talk to them. They're they're taking a patient, uh looking at the rough edges, saying what could make things better, rejuvenate.

SPEAKER_00 13:33

Yeah.

SPEAKER_02 13:33

Uh any any advice with woodworking?

SPEAKER_00 13:35

Yeah, yeah. Uh always saying uh with the grain. Always go with the grain.

SPEAKER_02 13:38

Go with the flake.

SPEAKER_00 13:39

The patient doesn't want to do it. You don't want to like, you know, uh force things on them. And you know, obviously you you work with the patient, right? What yeah.

SPEAKER_02 13:46

And I I had a number of patients who, you know, they would love that I would um, you know, spend an hour with a patient and and and that. And you know that I I really love to talk a lot. Okay, so I just and I have a patient that were like, you know, I'm glad I got in. You know, and like you're saying with concierge medicine, you can get in the same day or the next day.

SPEAKER_01 14:07

Right.

SPEAKER_02 14:07

But it's also that if you only want to have 15 minutes to cover a couple of important points, because you know, I've had patients who are very organized. I I want to know this, this, and this. I have these two questions and this medicine to refill.

SPEAKER_00 14:20

It's kind of rare. I I do have a few, like maybe one or two of those patients.

SPEAKER_02 14:24

But but most of them like to have the time to sit down and talk. But I'm okay with that.

SPEAKER_00 14:29

I'm okay with just giving information what if that's what you're doing.

SPEAKER_02 14:32

Yeah, it's the flexibleness. I I think the being very flexible. Also, it's the aftercare. I think as we've talked with a number of physicians, you're taking full advantage of when the patient leaves, they can get a hold of you for uh, oh, I forgot to ask this question. What's the what's the mechanism that you've you've you know you've left the visit, but also now you have a question? What what are what how how does the patient deal with that?

SPEAKER_00 14:57

Oh yeah, a patient can talk contact me through uh a cell phone. I have a cell phone on me, so they call me directly. Call you down. No middle man.

SPEAKER_02 15:05

They'll normally call you directly. Right.

SPEAKER_00 15:06

And then yeah, they also can message me on my chart as well, and it goes straight to my phone.

SPEAKER_02 15:10

Okay, so my chart is the sort of the patient portal that you can have on your phone. There's the option to message the physician, and from there it may be something that you'll see that your team members know exactly how to take care of, and they immediately immediately get that message. Exactly. So that's that. And that was that uh availability you have 24 hours a day. Absolutely. Okay, now if you're you you do take a vacation from time to time. I do. What happens then?

SPEAKER_00 15:35

Oh, we have trusted physicians that are amazing and um that can take over and uh take care of my patients for me while I'm gone. But I'm rarely gone, you know.

SPEAKER_02 15:43

So well, I love the hobby of of woodworking and things like that. And and uh it reminds me when I was in college just before medical school, I worked selling paint at Sears Roebuck in Tampa. And when the medical school asked me how did that impact, I thought for a moment and I said, you know, selling paint, I was often dealing with folks that were there because they didn't want to be there. They they they didn't like the paint, they didn't want to have to do the expense and and things like that. And I thought, how could I make this as as enjoyable as possible and bring the energy? Because it seemed to me a lot like how healthcare, you know, can't it can unfortunately be is like I don't want to go to the doctor, I don't want to take care of this or go into this kind of expense. But you know, tell you what, I started talking about what does paint do? It protects things.

SPEAKER_01 16:34

Right.

SPEAKER_02 16:35

You want to have the right paint, the right equipment. I'm so glad you're here.

unknown 16:39

Right.

SPEAKER_02 16:40

And that was a bit of a shock. Now I didn't did not work on commission, you know, but I felt energized to meet somebody who wasn't that happy. If I could get them to be a little more excited about painting that bedroom and and uh and and having the right product product for the right price, what they were invested in. And you know, I think I wrote that in my essay to get into medical school, not to say that's that was the key thing, but uh but it was something that I think you're bringing to medicine and your clinic with the concierge staff. It's to me, it's energizing. I want to learn more about concierge medicine. Um, what you're located at the Pablo Clinic, which is near the Southgate Mall, there on South Florida Avenue.

SPEAKER_00 17:19

Right, next to that Southgate uh yeah, Publix.

SPEAKER_02 17:21

And we'll put the phone number and we you're on our website, mylrh.org. But what's the number to call to learn more about concierge medicine?

SPEAKER_00 17:29

Yes, uh anyone can call uh to our office at 863-284-1765.

SPEAKER_02 17:36

You know, when I think about the concierge medicine and and uh you know the things we do to help us feel better, we you know, we we join a gym and we we pay a gym to be a part of that member, or we get relaxation through streaming television and we pay those subscription fees. I think the the option of having your expertise and I think the uh issue is multi-talented. I like the idea of the the hands-on, the millipetive therapy that goes on with uh being a doctor of osteopath, medicine. So that that's that's pretty key.

SPEAKER_00 18:09

Yeah, that's one of my favorite skills. Uh to be able to see the relief in pain, uh, the improvement in anxiety, improvement and and insomnia, uh like the few things that I do do treat with my hands, uh, to be able to see that without injecting somebody. Yeah.

SPEAKER_02 18:24

It's just a a gift that, you know, like I just that hour, that that time you get to spend with the patient, you're going beyond just the medical physical issues, but you can deal with the sort of the heart and soul and medical issues that often are tied together with behavioral medicine and mental health. That brings up another issue with concierge medicine. Sometimes your patients might need a specialist, they might need uh uh help with ups and downs of life or a heart issue.

SPEAKER_01 18:53

Right.

SPEAKER_02 18:54

I bet your team is really on top of smoothing out that process because you literally need a navigator to get through some of the of the referrals and the authorizations, things like that. Is that how does that been going?

SPEAKER_00 19:07

Yeah, concierge medicine doesn't uh automatically bump us in front of the line uh with uh our specialists. We love our specialists. I'm so thankful to work in an organization that has all these specialists available to me. And my employees have time, or my my staff has time to call these specialists and um repeatedly sometimes and I think I've even seen them walk upstairs to the cardiologist and just say, let's have a face-to-face meeting.

SPEAKER_02 19:34

I myself have walked up to the back.

SPEAKER_00 19:36

I was like, oh, might as well just go greet my other specialists.

SPEAKER_02 19:38

So at Pablo, you have cardiologists and gastroenterologists, uh urology. I could see a lot of of the urology needs all these needs that it's you know, you're the you're the captain helping organize this. And and as a as a concierge medicine physician, you're there to to sort of translate things that go on, how to get the most out of these visits.

SPEAKER_00 19:59

Yeah, that's the other thing I see that uh um, you know, with doing traditional medicine, uh you don't get the chance to walk out there and do things sometimes with most of the time because I used to go out in the waiting room and bring my patients back as opposed to having their name called.

SPEAKER_02 20:13

I would go out there and shake their hand and say, hey, come on back. Right, right. Sometimes my team would get upset with me because they didn't they didn't sign them in yet. But hey, we'll we'll f we'll figure out that later. But you also get to see not just the patients. Sometimes you officially have the family is also seeing you, other family members.

SPEAKER_00 20:29

Oh, absolutely. Like especially when they come in a company with uh the patient. Yeah.

SPEAKER_02 20:32

And then your room is big enough to hold a few people.

SPEAKER_00 20:36

Yeah, yeah. I can you know at least hold three more people in there. Oh, perfect. But you know, when they see me interact with their family member, they're like, you know, that's like a type of advertisement. They're like they see me working and they they want it too. So, you know, they're have the ability to see what I'm all about before they buy in.

SPEAKER_02 20:51

Yeah, I think that helps that you know that that uh folks talk about it, and it's good just to call, find out the details, find out what, you know, is this right for you. In fact, I would almost have to say, you know, today's interaction almost feels like the kind of interaction I'd get as a patient. We've, you know, you've given me some really neat information, but it was also I felt comfortable asking you hard questions, asking you questions off the cuff. But that's what a doctor's appointment is. You know, you know, each patient comes with their own personal story, and I'm glad you're giving them the time to have this kind of interaction.

SPEAKER_00 21:27

Yeah, thank you for giving me this time. Oh, I appreciate it.

SPEAKER_02 21:29

This has been this has been very helpful because it ties in with everything we've been saying about what matters most to the patient. And this is the care available right here in Lakeland, Florida. So we're we're happy to have you and good luck with everything.

SPEAKER_00 21:42

Yes, thank you so much, sir.

SPEAKER_02 21:43

You're welcome. Hey, take care.