Last week I was invited to talk at the DC offices of One Medical Group, which was a healthcare startup back in 2009 when I finished residency (I interviewed with them for a job, as a matter of fact). Now it’s a going concern, with branches in San Francisco, New York, and DC — and, now that I look at their web site, in Chicago, Boston, and LA, as well. One of my friends from residency, Will Kimbrough, is the medical director of the DC office. He is an incredibly smart guy, consummately professional, innately humble, and not afraid to call out bullshit: powerful virtues make for a clinical leader and builder.
Nevertheless, before I knew Will was working there (and, to be honest, maybe for a bit after) I had my assumptions about One Medical Group – because it practices concierge medicine. Concierge medicine is for rich people, I thought. “Thought” is maybe a strong term: it was my assumption, born of ignorance and lack of acquaintance with such a model.
I can’t say that I am now intimately acquainted with a concierge model after an afternoon at One Medical Group. But I had a good time giving a short talk to a group of energetic, young doctors who told anecdotes about patients that sound an awful lot like mine. I still wouldn’t rely on the concierge system to fix our American health care holes, but it might indeed be a reasonable way of providing care to those that can afford it. And, who knows, maybe the price and quality transparency that have long been a natural, unquestioned characteristic of markets for other goods – cars, groceries – might make its way into the health care market in part through such private companies.
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Sean Looney was a high school friend of mine, a tall guy who was often smiling. Our group of nerds thought we were hot shit (in a quiz-bowl, socially awkward sort of way), but he alone among us seemed to realize that it was worth our while to try and act like normal people, even though we were more academically oriented than others. Or, at least, not to be irremediably dorky.
After getting a liberal arts degree, he went back to medical school and completed a family practice residency in Cheyenne, Wyoming; he told me about an instructor who could tell the caliber of a bullet by the sound it made falling into a metal bedpan. He then practiced medicine in many places across the country, but in these last years in Pikeville (county seat of Pike County, Kentucky), and in Louisville. He got married.
We weren’t really in close touch since high school, and I couldn’t make it to his wedding. But I did remember the kind of patients he said he took care of in Louisville: alcoholics with schizophrenia. Problems that are not, to be honest, on the pages of the New England Journal too often, and not the subject of fancy clinical trials.
Sean died suddenly last week at the age of 40. His close friends, wife, and family are heartbroken. When I called his mom, I tried to tell her that he is, and was, an inspiration to me.
Sean’s sympathy for people was informed by a love of literature. Sean, me, and our mutual friend Jon (who I have known for a long time, even longer than Sean) used to quote El Cid and Spanish romances to each other. He freely cited musicals and I remember he loved opera.
A healing art needs humaneness, a fertile mind and heart, like those Sean had.
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Like concierge medicine, we can’t build our entire health care system on the safety net, but we want such humaneness for people of all strata.