We specialize in chronic illnesses that are poorly treated in the insurance model now, in western medicine--chronic fatigue syndrome, fibromyalgia, diabetes, MS, thyroid dysfunction. If you look at thyroid dysfunction, people go to their doctor, the doctor runs a simple TSH test because it is very easy. You can do it in minutes. But it misses 80 percent of people. But if you do a 20 to 30 minute clinical evaluation you can diagnose so many more people with thyroid problems. People are running around with depression, can't lose weight, fatigue; the endocrinologist says you are fine. But if you do a more thorough exam and evaluation, they will determine that more patients are low in thyroid function. You treat the thyroid and their whole life is changed. But doctors say, "but I can't spend 30 minutes with a patient."

DM: What is your view of the health care reform effort?


KH: In a word, it will be a disaster. They tried a public option in Hawaii and they disbanded. Costs spiraled out of control. Massachusetts has a public plan and it's the worst health care in the country. You have to wait three times as long for a specialist. Doctors are leaving there.

You look at Medicare and how they plan to save money by decreasing reimbursement. Right now, Medicare pays [only] 80 percent of what it costs doctors to do a procedure. How much more can you cut? The waste, fraud and bureaucracy is where all the money goes.

DM: Do you have Medicare patients?

KH: We have opted out.

DM: So tell us how your model works for a typical older lady with a thyroid problem.

KH: The patient pays the office visit up front and the labs [blood tests] can either be billed to insurance or billed in cash, as well. But you are giving a good service. With the non-insurance model, we have to get the patient better. We have to give the best care, where the patient says, this is worth it for me. The insurance model is great for bad doctors who don't care. They just try to see as many patients as they can. They don't care, so they spend only five minutes with the patient. Doctors who can and want to spend time with their patients and do what is right get very frustrated with that model.

DM: You mentioned that doctors are thought of as "providers." Similarly they are sometimes called "prescribers."

KH: All the insurance companies have done that, delegated them to providers and prescribers for their plans. There is a big disconnect because the doctor does not work for the patient. The doctor works for the insurance company [in the conventional model]. And he knows he is going to get more patients from the insurance company, especially if he is a cost-effective doctor, rated high by the insurance company, meaning he doesn't do anything and basically makes the insurance company a lot of money.

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