If I Betray These Words by Wendy Dean & Simon Talbot

Author:Wendy Dean & Simon Talbot [Dean, Wendy & Talbot, Simon]
Language: eng
Format: epub
Publisher: Steerforth Press
Published: 2023-04-04T00:00:00+00:00

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Rita had never been one to do what was easiest. As she always did when faced with a difficult decision under duress, she leaned on the army values that had served her so well — duty, honor, integrity, and personal courage.

On the drive home that October day, she thought about the community she had come to call home. So many people, too many of them living in poverty, needed better access to high-quality primary care. She and Rudy had moved to this town to be near family, and she did not want to uproot her children. By the time she pulled into her parking spot beside the ancient apple tree still adorned with the last remnants of the fall harvest, she’d made her decision. As her children raced across the grass to greet her, she knew the only way to keep this life and stay true to herself was to go all-in on the direct primary care practice.

She paid cash for a foreclosed 1940s building in a tiny town just down the state highway from her farm. The house is next door to a gas station and general store, halfway between the high school and the United Methodist church. There are hospitals in each cardinal direction from her new office — fifteen minutes north or south, double that distance east and west. For the first few months, Rita, Rudy, and members of the community worked nights, weekends, and holidays to turn the building into a medical office: installing ramps, rails, a locked medication room, a new refrigerator; giving it a fresh coat of paint. She bought barely used equipment at bargain prices from one of the local hospitals that was redecorating and furnished the waiting room with donations and thrift store purchases.

The practice is both bare-bones and full-service. Rita employs only herself, a part-time nurse, and a part-time receptionist. She sees her patients in two-hour-long annual appointments and hour-long follow-ups, though she will take as long as a patient needs and will even make house calls if mobility is an issue for someone. She contracts directly with laboratories and imaging centers so her fees for tests are a fraction of those at the local medical center, often less than a typical insurance copay.

Direct primary care isn’t a panacea, though. Rita is on call all day, every day, all year long. If she had been saddled with education debt, she might not have been able to choose this path. Like most physician families where both partners work full-time, Rita and Rudy have a team of people helping at home — Rudy’s extended family and a live-in nanny — otherwise, such a schedule would be impossible with three young children. Her panel of patients is much smaller than a traditional physician practice, which allows her to spend the extra time with each person, but if all primary care doctors changed to the model, it would be hard for patients to find a doctor. Rita doesn’t participate with insurance companies, so

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