You've heard about farm-to-table restaurants. But what about a farm-to-examining table medical practice? The latter is essentially how one might describe Ethos Health, a primary care practice situated alongside a 348-acre, 18th-century farm in Long Valley, New Jersey.
The farm-based practice has been in operation for about a year. Its founder, Ronald Weiss, M.D., a graduate of Rutgers University–Newark and New Jersey Medical School and current assistant professor of clinical medicine at New Jersey Medical School, became inspired by the healing power of food when his father was diagnosed with pancreatic cancer in 1992, according to Rutgers.
As I read Weiss's story, I thought it represented a great example of a physician crafting a custom practice model to fit his passions and served patient needs. And if the patient stories of vastly improved health, as described by NJ.com, are true, Weiss and his team are effectively addressing problems so many primary care practices have in educating and engaging patients to follow healthy lifestyles.
Ethos' offering for "A Year of Mindful Living," which teaches attendees healthy ways to shop, cook and eat out in the real world, sounds especially, well, great. It made me think of my friends who belong to Community Supported Agriculture (CSA) programs and come home with crates overflowing with gorgeous, vibrantly colored produce, only to set it on the counter and say, "Okay, now what do I do with it?" I suspect that in many cases, more of that beautiful food gets "liked" on Instagram than actually consumed.
But when you get to the fine print on the Ethos website--which actually isn't hidden at all--the $5,000 cost of the yearlong workshop presents itself. Taking the courses isn't required for membership to the practice, according to the FAQs, but is strongly recommended to make the most of the medical visits (which cost $250-$500 each for non-Medicare patients).
With another of this week's top stories about the often-thorny relationship between medicine and money freshly in mind, the Ethos Health story elicits plenty of food for thought (yes, I meant to do that):
- Do fee-based practices create a tiered-health system? Is it fair to offer potentially life-changing services for some while many can't afford to join?
- Is it financially or physically possible for a traditional practice to offer patients a comparably effect amount of time and education to direct and fee-based practices? Could a well-run patient-centered medical home paid by insurance contracts, for example, get its population truly invested in its health?
- It makes sense that people who invest significant dollars in health and wellness would be mentally invested in health-conscious behavior. But how are medical providers to persuade the insured--who put plenty of cold, hard cash into the system themselves--to protect that investment with their own energy and effort?
- Do value- or quality-based reimbursement systems unfairly penalize physicians who are unable to engage patients who are simply not motivated to care for their own bodies?
Answers to these questions are a matter of opinion. I think the ethical way for a physician to practice is in a manner that reflects what he or she personally believes is fair and right, keeping in mind, too, that a miserable doctor at a bankrupt practice will have a limited (if any) capacity to make a difference for patients. - Deb (@PracticeMgt)