Choosing Healthcare Strategy that Pays – The wisdom of investing in proactive, primary-care models

By Dr. Susan Wilder, LifeScape Premier

The employee healthcare burden puts American companies at a global disadvantage. American health care consumes nearly 18 percent of our GDP, crowding out every other spending priority, yet delivers a poor return on that investment.

We fall behind other developed nations in life expectancy along with virtually every key health metric and dimension of a high-performance health system. Despite our massive expenditure, we suffer more years disabled by chronic disease. Our system excels at rescue but fails miserably at proactively optimizing health and productivity of our citizens.

Increased healthcare demand, fueled by aging boomers and millions gaining insurance through the Affordable Care Act, threatens to further inflate costs and reduce quality-care access. The physician shortage in Arizona is predicted to be among the worst in the country. Insurers and medical centers fill the gap with lower-cost physician extenders (PAs and NPs with a fraction of a physician’s training) or by promoting “fast-food” kiosk medicine in drug stores.

Primary care is the base of our healthcare pyramid, and quality primary care improves health outcomes while reducing cost. However, if our physicians continue to be undervalued, forced into hit-and-run medicine throwing drugs at symptoms, costs will further inflate while our collective health will plummet.

Proactive companies are changing the paradigm. Rather than spending liberally on ever-increasing premiums and wellness programs, they are investing in retainer-based, personalized primary care for their employees. This is paid for directly rather than through an insurance middleman. The cost is offset by less expensive, high-deductible insurance for “rescue” care.

Investing in proactive, preventive primary care pays off with a healthier workforce, lower absenteeism and reduced overall healthcare costs, which should favorably impact premiums.

Patients desiring personalized care or with complex care needs should invest now in the myriad direct primary care models including concierge- or retainer-based care. Insurance plans and Accountable Care Organizations would be wise to invest in retainer-based models for their most costly and complex cases.

Engaging proactive health care is our only hope of shifting the cost/quality curve. As Winston Churchill said, “Healthy citizens are the greatest asset any country can have.”  He also said, “You can always count on Americans to do the right thing, after they’ve tried everything else.”

Susan Wilder, M.D., is the founder and chief executive officer of LifeScape Medical Associates and LifeScape Premier, 8757 E. Bell Road. Following her military service, Dr. Wilder served as founding director of the Mayo Clinic Scottsdale Family Medicine residency program. She has gained special expertise in personalized, functional medicine with a focus on primary prevention and addressing underlying causes of illness while reducing reliance on medications. For information on Lifescape’s concierge-care program, call 480-860-5269, ext. 120; visit