As part of a lifestyle and aging series, we’re working with renowned photographer Terry Lorant to showcase inspirational leaders in the industry. Each month, we’ll feature one or a few inspirational member(s) of the Amazing Care Network community who is using his or her voice to empower others in the collective aging experience. Read, in their own words, what the Amazing Care Network’s efforts mean to them.
This month, we’re proud to feature Dr Bob Uslander, “Dr. Bob,” has been practicing medicine for more than twenty-five years, currently as a concierge physician leading a team of holistic practitioners serving the elderly, those experiencing complex illness and end-of-life. He is dedicated to helping people live with joy, and without fear and struggle, at any stage of life, and especially in the face of challenging or terminal illness. To Dr. Bob, there is no group of people more deserving of and desperate for this type of care, than those facing these challenges, and the people who love and care for them.
While his training was in emergency medicine, his career has evolved toward taking care of the elderly and those nearing the end of their lives. Since 2003, he has focused on creating and working with practices and programs that help the elderly and clinically complex members of the community receive excellent health care. In 2003 Dr. Bob created Sierra Housecalls Medical Group to provide medical care to the homebound and elderly members of his Northern California community. In 2004, he helped form Seniority Life Care at Home, a provider of non-medical in-home care for seniors, which allows them to remain in their own homes more safely and independently. He was a founder and past president of Sierra LifeNet, a non-profit organization dedicated to meeting the needs of the frail elderly, including the operation of a local Adult Day Health Care program.
Dr. Bob is a member of Amazing Care Network and has been a guest speaker at our ACN teas. Below we share Part 1 of a Q&A with him, for insights into his world of concierge palliative care through his practice, Integrated MD Care (IntegratedMDCare.com).
ACN: Tell us a little bit about how you got interested starting your own practice as a concierge physician, to help patients and their families with end of life?
Dr. Bob: I was working in palliative care and hospice, recognizing the value of those services but also the severe gaps that people were still struggling with almost universally.
ACN: What are some of the common challenges you see from your clients?
Dr. Bob: We have a lot of people who are aging away from their families and find themselves isolated. They may not even be isolated, but when their health becomes challenged, if they don’t have somebody who’s with them and available to advocate, then bad things can happen. That’s unfortunately the norm.
What I’ve discovered is that most people believe that when things change for them and when their needs become more significant, that the system will be there to take care of them because it has been when they’re sick in the past.
ACN: Where does the care go wrong?
Dr. Bob: Sometimes they can call their doctor and get in or they go to urgent care or to the hospital, and their acute needs are met. But, when they start having more complex needs and they start seeing multiple physicians or they’re going to the hospital in and out, they need help with coordination, it doesn’t happen. The system is really designed to protect the system and to make money.
Even though there are many individuals in the healthcare system who are great people and have big hearts and are compassionate, they’re unable to do the work that they’re either meant to do or want to do because the system doesn’t support it. And that goes at every level. So, people find themselves in this place of total overwhelm and disbelief.
I can’t tell you how often I talk with people and they tell me, I have no idea how this happened, I don’t know how we got here, and I don’t know what to do. We don’t even know where to go first. Because there are so many issues, so many things that they need to attend to.
I’ve had a real interesting education about all of that both from being an emergency physician, and then being in palliative care hospice. Amazing Care Network is one way to try to add additional support and value. ACN’s doctor “Friend of the Family” advice service is a great concept.
ACN: How has it been working with attending physicians in your new role as a concierge physician?
Dr. Bob: A lot of times they may be guarded and skeptical of what my role is or what my motivation is. But, I’m pretty adept at communicating that we all have the same goal. The goal is to make sure the patient has the best experience and the family feels supported. I recognize the value that they bring. I’m just trying to see where we can add more value. I recently had a conversation with an oncologist regarding a patient and it started off cool. I could tell he was wondering who I was and why I was involved.
I told him, “I’m a friend of the family, I’m a palliative care doctor, and I spend my days helping people see all the different options available to them and trying to make sure that they have all the information to make informed decisions. I know that you went through all of this with my clients, but there are more questions that have come up and they don’t understand things the way that we do. I’d really like your honest thoughts about what the options are and your thoughts on what you would recommend given these circumstances.”
I was able to share a little bit more about the circumstances since he had last seen them. So, he went through all the different thoughts with me and I asked questions about the impact of the treatments. Near the end of the conversation I asked, “So if this was your father, what would you do?” He didn’t quite answer it directly but he made it pretty clear what he thought would be the right thing in this circumstance, given what he knew about the impact of treatment.
By the end of the conversation he had really warmed up, and said “It was really great talking with you, I’m so glad that you’re involved and helping him.”
For the most part that’s the way doctors want to work. That’s how they want to be. They want to be collaborative.
Stay tuned for Dr. Bob’s Part 2 next month!