07/05/2023    Robert Kornfeld, DPM

Ability to Have a Concierge Practice (Elliot Udell, DPM)

May I say one thing on the subject of change -
Knowledge is knowing that a tomato is a fruit and
not a vegetable. Wisdom is knowing not to put it in
a fruit salad. In my opinion, insurance-dependency
is like putting too many tomatoes in your fruit
salad and allowing it to overwhelm the sweetness
that you could otherwise enjoy.

Dr. Udell, many podiatrists all over the country
have already included therapies into their practice
that are not covered by insurance. They also sell
products. That approach is called a hybrid
practice. The difference is that these docs depend
on services that are covered by insurance and then
privately contract with patients for direct payment
for non-covered services.

Because of my 36 years of experience with a
functional medicine approach, what I have been
sharing here for decades is that relying on the
next better modality still leaves the patient out
of the mix. By that I mean that difficult to heal
patients do not struggle to heal because you
haven't used the "best modality". They struggle
because there are burdens on their immune system
that create inefficiency in repair, replacement,
replenishment and detoxification pathways.

I have had a long and successful career practicing
this way (hybrid until 2000). All you need to do is
look around and pay attention and you will see
thousands of MDs and DOs who are now practicing
functional medicine. Why? Because every patient has
a right to know what mechanisms are causing them to
cross the morbidity threshold that also leaves them
vulnerable to downstream pathology that hasn't
manifested yet. And when they are addressed, that
is true healthcare.

The majority of my patients have been failed by
traditional medicine numerous times with many
doctors and I apply the principles and get them
well. Yet, in spite of their misery and challenges
with insurance-dependency, our profession has dug
their heels in and has refused to embrace this
paradigm that not only allows far better outcomes,
but frees you from the bondage of insurance. Dr.
Udell, anyone who convinces themselves that their
bed cannot be remade, will continue to suffer at
the hands of insurance companies who exploit and
abuse you and it will only get worse. To me, that
is victim-mentality. And that is exactly what has
enabled insurance companies to be able to steamroll
all over your practice and make you jump through
hoops for pennies. That's not what I signed up for.
So I walked away from the madness a very long time
ago.

Robert Kornfeld, DPM, NY, NY

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