Frequently Asked Questions
Answered by Dr. Stewart
After 25 years of doing Family Practice, why is Dr. Stewart just
doing diabetes and lipid care?
What insurances will
you take?
Will there be any extra fees to be a patient here?
What
are Virtual Visits?
I
am used to sending Dr. Stewart emails with questions and requests.
Will I be able to continue doing this?
If Dr. Stewart will have no employees, how will I schedule an
appointment?
Why
doesn't Dr. Stewart hire some help?
What will I do if Dr. Stewart goes on vacation?
What hours will the clinic be open?
How
far ahead can I schedule an appointment?
Q: After 25 years of doing Family
Practice, why is Dr. Stewart just doing diabetes and lipid care?
A: I very much enjoy the breadth and diversity of Family Practice, but
I have found that I particularly enjoy the challenge of taking care
of patients with diabetes and lipid problems. The problem is, these patients usually have a host of other problems, and they require much more attention than the average healthy adult. To provide the quality of care I would like to provide, including the availability to see patients as often as they should be seen for both their chronic disease management as well as acute illness needs, I can not realistically maintain a panel of more than about 800 patients. In fact, I will probably not sign up more than 600 patients until I am sure I can handle the volume.
As of June, 2007, somewhere between 2,000 and 3,000 patients considered me
their "primary care physician." The reality is that the majority of
these patients may not have seen me more than once every few years, and
when they were ill, they usually ended up seeing one of my associates
at Swedish Physicians Pine Lake. Because my schedule was often booked
out for weeks to months at a time, they are not able to easily
schedule routine health screening visits, and often would have some of
their needs neglected because of the limited time available during
the visits they were able to schedule. At this point in my life, I
choose to provide superb care to a limited number of patients rather
than inadequate care to a large number.
Q: What insurances will you take?
A: I intend to apply to be a provider for the majority of plans that I have
accepted in the past. Some plans may not accept me, since I was
contracted as a member of the Swedish Physicians group, and they may
not be interested in contracting with individual physicians. There
may be some plans I choose not to contract with due to high
administrative burden. Plans that I currently am contracted with
include:
Regence Blue Shield, Premera Blue Cross,
United Health Care,
First Choice Provider Network.
My application to Medicare is in process, and will eventually be
approved. Medicare allows doctors to see patients before the application
is completed, and pays them after approval.
I am currently applying to the Washington State Healthcare Authority for care of State Employees.
Secure Horizons and PacifiCare have been very problematic. They were recently purchased by
United Health Care, and they have not come to a decision about what they will do with provider
contracting. I have been in contact with them for many months, but have not had an answer yet.
Aetna has had my application for many months. I am still waiting for an answer from them.
Plans I will not be contracted with include:
Group Health Cooperative,
Medicaid, and Washington State Labor and Industries.
I will keep the list updated as I get information from the various health plans.
Q: Will there be any extra fees to be a patient here?
A: Although Sammamish Diabetes and Lipid Clinic is organized like a "Concierge" practice, where patients typically pay hundreds to thousands of dollars each year in order to remain patients, we will charge no additional membership fees, with the exception of a small yearly fee to maintain secure internet access to each patient's records. At this time, the fee is expected to be $50.00 per patient per year
or $75.00 per family per year
This fee will provide a secure internet gateway for each patient to view his or her personal medical chart, including visit notes, lab, and imaging results. Patients will be able to securely message Dr. Stewart with questions through this gateway, and will be able to receive responses securely, too.
Additionally, when it is appropriate to do a "virtual visit,"
where an established patient might be treated over the
internet without a physical office visit, this $50.00 will cover the
costs of all such visits for a calendar year.
Q: What are Virtual Visits?
A: An example of a virtual visit would be a
follow-up visit for hypertension, where the patient has had a change
in medication and needs to report current blood pressure readings
and side effects of medication, but does not need to be physically
present with the doctor. Another example of a virtual visit
might be a follow-up of a patient with depression who is stable, but
needs to check in for a medication refill. Or, a patient with
diabetes who needs to review blood sugar results and side effects
between his regularly scheduled diabetes visits.
Currently, virtual visits are not covered benefits by any insurance
companies, but they might prove to be a much more efficient way of
dealing with some medical problems than to have a patient take time
off of work for an encounter that does not require a physical
examination by the doctor.
Q: I am used to sending Dr. Stewart emails with questions and requests. Will I be able to continue doing this?
A: Because email is not
secure, Federal Privacy Laws discourage its use for medical
problems. Patients can ask any questions they wish via email without
penalty, but HIPPA encourages physicians to respond to patients in a secure way, so as to minimize the risk of
private medical information becoming public. Consequently, responses
to emailed medical questions from patients will be available through
the secure internet gateway, rather than with unencrypted email.
However, simple responses such as verification of prescription
refill will still be available by email, if requested by the
patient.
Q:
If Dr. Stewart will have no employees, how will I schedule an
appointment?
A: The easiest way to schedule an appointment will be on-line from this web Site.
Go to the Patients Only
page, then click on Click
Here for Appointment. Phone calls to schedule appointments will also be possible, but will usually go to the answering machine. They will be returned by Dr. Stewart when he is between patients.
A: As a micropractice, Dr. Stewart practices
"solo-solo," with no employees. This means that Dr. Stewart will answer his own phone, will handle prescription refills himself, and
will room patients himself. His wife, Eva, who is a retired Nurse Practitioner and Certified Physicians Assistant may occasionally
help him with the phone and with greeting patients. Although hiring a receptionist and medical assistant would make patient flow more
efficient, it would also require that Dr. Stewart see more patients every day to pay their salaries and benefits. With finite numbers of
hours in a day, this would mean shorter visits with patients, and less time with the doctor.
Q: What will I do if Dr. Stewart goes on vacation?
A:
Medical emergencies should generate a 911 phone call. Dr. Stewart's cell phone will be listed on the answering machine when he will be out of town but within reach of cell phones. In the event that he will be travelling to a location where no cell phone access is possible, there will be clear instructions for contacting a covering physician on the answering machine or web site. Patients will always have secure 24/7 access to their medical charts over the internet.
Q:
What hours will the clinic be open?
A:
We will initially attempt to be open for patient visits about 20 hours a week. In order to
accommodate patients who do not want to take time off work for a visit, we will have evening and weekend hours available on a regular basis. The actual schedule may vary from week to week, but will be easily viewed on the on-line scheduler. Since the office is in Dr. Stewart's house, we will have quite a bit of flexibility with respect to urgent and after-hours visits.
Q:
How far ahead can I schedule an appointment?
A:
Using AppointmentQuest, we have set up appointment
scheduling up to 6 months in advance. Because there will be a
limited number of patients in the practice, appointment scheduling
should be much easier than it has been in the past. If you wish to
schedule an appointment further out than 6 months, please email Dr.
Stewart, and he will set up a time further out for you.
office (425)
996-7047