Our Philosophy
Approachability
Patients tell me the primary reason they chose me as their physician is because a friend or coworker told them I listen. They also thank me for not wearing a white coat, for having my staff wear normal clothes, for making eye contact and for not staring down at my computer the whole time while they share very personal aspects of their lives. Healthcare is becoming detached from patients and it is becoming harder and harder to keep that detachment out of the exam room. Three Peaks Health was created to preserve a care-focused environment (which is one huge reason why we don't take insurance).
Honesty in care
Modern medicine is increasingly becoming more about catering to lifestyle choices than it is about being honest with people. In my traditional medical practice we often talk about the difference between what you want to hear and what you need to hear. Patients now view themselves as customers and the care team is there to serve them as if we work in a resort. While it is very easy to play along with that approach as an industry (as evidenced by direct-to-consumer pharmaceutical marketing and one health system building a fancier office building across from the one a "competing" system just finished across the street) we need honest conversations about your health. This observation is of course not to be confused with a patriarchal view where the physician knows best; rather, I want highly-motivated, fully educated and empowered patients (that's called patient engagement...the lack of which is another problem with the current healthcare system) where we work together to better your health. I am always going to tell you what I think. This approach is not for everybody and there are certainly plenty functional, integrative and concierge practices around for those that are looking for someone to nod their head and write for the prescription of the day.
Complex cases require a lot of time
One area my patients and myself (also a patient) often find frustration is in the inability to have sufficient face-to-face time with a physician - the issue is clearly present in traditional medical settings but also in functional & integrative medical settings and yes, even within the holy grail of concierge medicine. At Three Peaks we're taking that one step further and making a space where patients with complex conditions and patients who understand that wellness isn't achieved by simply completing their annual physical exam can access additional physician time to work through their conditions and concerns.
What took years to take hold may take years to unravel
This gets to the heart of the honesty in care described above. Complex conditions generally do not happen over night (although they sometimes seem to and sometimes do) but take many years and decades to become an issue - research the, "overflowing bucket theory of chronic disease." The accelerating rates and earlier age-of-onset for cognitive decline in the elderly are a prime example. I once had a traditional medicine patient in whom I noticed very slight cognitive changes. I pointed this out to the patient and their wife who were both deeply offended that I would make such a statement. They agreed to a limited scope of treatment and told me, "I will take no more than a total of four pills - that includes prescription medications and supplements." As I was unable to operate under such confinements they hunted around until they found a prescriber that satisfied their care expectations. When the wheels fell off ten years later they called me saying, "help us we don't know what to do." Of course by that point in time there was not much that could reasonably be offered.
This is why it so important to come in for an extended holistic preventive consultation - so we can review a wide variety of life factors to see if there are areas in need of attention and develop a plan to address them in the order of importance. This is particularly important for women.
For those who find themselves with a complex condition I am not going to tell you there is a quick fix. I wish I could and if that is the case we will certainly pursue it; however, given you likely already completed a conventional medical workup and find yourself stuck and out of runway I am going to tell you the opposite. We have to understand how this came about. What were the circumstances / environment under which this process thrived? That will take time to figure out. What have others concluded you are dealing with? That will take time to read (the notes of your other physicians, lab results, imaging reports, etc.). What new paths do we need to investigate? That will take time. Just figuring out where you are takes time and effort. Then, once we have a treatment plan, that will take time to execute. We are very, very focused on keeping you engaged in life's activities. More often than not people impacted by complex chronic illness have a lot of demands placed upon them (the intense stress being one chief factor in the lead up) - we place great effort on engaging the processes (e.g., Lyme, etc.) while keeping you as functional and operational as possible for those that need you in everyday life. For kids this involves keeping them engaged in school on a daily basis as there is no replacement for lost content and social interaction.
This is a long-game proposition and will require a departure from the typical thinking of, "a pill for the ill." That being said our focus is similarly on making progress as quickly as reasonably possible (which is usually a function of patient tolerance of their personalized protocols).
No two patients are alike
Another practice I see in "individualized medicine" is the use of a lot of protocols. I experienced this first-hand at a high-dollar practice in town. When we work together we are working on you and you alone. While some foundational aspects to health can be generalized, this quickly turns to a personalized approach. Everybody will have different genetic predispositions. Everybody will have a different lead-up to their current circumstances. Everybody will have a different mix of factors contributing to their current situation. A big part of the process is to set aside the practice of herd medicine and to look at the particulars regarding your specific case.
Why we are not a concierge medical practice
It would be infinitely simpler to form a concierge practice, fill it with 400 patients, charge everybody a $200+ per month "access fee" on a subscription basis, charge them beyond that for each "extended" office visit, and call it a day; however, I believe it is more important to be there for people when they need you and as they need you. I just can't imagine perpetually charging people a membership fee when they are already expending significant resources on supplements, testing, conventional medical workups, alternative medicine workups and the like. For the time being we are going to test the model where I am here for consultation when you need me. Some of these needs will be short and well-defined while others will be lengthy and indefinite.
Why we pursued a micro-practice structure
It is all about eliminating as many distractions as possible. After having a mid-sized solo practice for 20 years I'm choosing to get back to a place where I have more time for patient care, even though that means I will see fewer patients. I have observed time and time again the shortcomings of everything that promised to bring efficiency to the practice of medicine. I spent the first third of my life in training learning to help patients and I am intent on getting back to a place where I spend more time caring for patients than I do on paperwork and logistics.
Why it's so hard to help kids
I always had a heart for kids and the physicians who cared for me as a child influenced my decision to become a doctor. In medical school and then in residency it became clear I could not be a pediatrician (as I once thought) simply because while I felt deeply for the needs of the child and could certainly help them I was not cut out to navigate the emotions and demands of the parents. We could write extensively on this subject. Generally speaking I do not treat kids; however, I am open to inquiries if you, after reading everything on this page, commit to keeping your emotions in check and committing as a family to the long-term needs of your child.
Why we had to create a separate practice to perform functional medicine work
Conventional medicine provides 15 minutes for a simple patient visit, 30 minutes for a complex patient visit or physical exam and 45 minutes for an extremely complex visit. I so often had patients I was trained to help, could help and still had to refer to other functional medicine practices since there was no way I could help them in 15, 30 or even 45-minute increments. It is simply not possible to get into highly-detailed cases in a conventional medicine setting. Insurers will generally not cover it nor the testing required. Conventional patients, accustomed to co-pays and "pill for the ill" medicine, will also not pay for it. Beyond this, I had to create a physical space away from my conventional practice as the techniques and mindset utilized in the two are so different.