Paul,
I have been practicing medicine in Springfield Missouri for over thirty years. The first half in emergency/trauma and the last half in family practice - most of the last half in an independent 125 physician clinic. I left shortly after we were purchased by a local hospital.
For the last few five years I have practiced medicine in an on site clinic. There is no insurance involved. I am paid a set amount and the practice is "turn key". My patients and their dependents have unlimited office visits at no cost to them.
Insurance companies do not, as a rule have an interest in prevention, but the guys who really pay the bills (the employers) do.
I am told that over a third of the self insured companies on the eastern seaboard have on site clinics.
I am convinced that this is a model that could also transer to the indigent, but it will have to be proven in the private sector first.
This is the most enjoyable practice I have ever had (although I have always been happy with my medical practice). I share Martin's enthusiasm. Why don't you come to Branson next month and Bert, Brian, Martin, Leslie and I will all buy you a beer.
Best,
Jim
