 Doctors’ Duty & Trust
Trust between patients and their doctors has always been essential to medical care. Of what use are the best communication skills, physician empathy, or clinical knowledge if patients don’t trust the advice and information that their doctors give them? The most important duty of doctors is to provide care that is in the best interests of patients, or in other words, to do what the patients need. In addition, many doctors are involved in non-patient-care activities. For example, some doctors often:
Through these activities, doctors often develop relationships with various people, businesses, and organizations. Although their underlying goals may be to improve medicine and patient care, doctors may also benefit financially from some of these relationships. For example, a doctor who is involved in developing a new medical device may receive payment from the medical device company, or a doctor who has invested in owning a CT scanner at a treatment center, may profit in some fashion when people go there and get a CT scan (whether it’s needed or not). Although money is involved in the interaction between patients and physicians, the practice of medicine differs from that of other businesses. Sick people are not consumers in the mercantile sense. They cannot (freely) shop around. They are not looking for bargains. Serious illness entails much less control, higher stakes, and intense vulnerability. Trusting a finance account manager, even with one’s life savings, poses much less distress than trusting a cardiac surgeon. The relationship between a patient and physician is not a commodity transaction or contract, but a covenant—a formal, solemn, special kind of promise, like a will or testament. Whereas a contract is a binding agreement which benefit and protect strangers, a covenant is between parties who have a close relationship with each other. Whereas a contract is based on mistrust, a covenant is based on trust. Whereas a contract is between two equal or near-equal parties (each concerned only with its own welfare), a covenant is between two unequal parties—where one is concerned about the welfare of the other. The covenant that patients expect from physicians is “to put a patient’s interests first.” The physician is the final common pathway for every act done to a patient. No order can be carried out without the physician’s assent. The physician cannot, or should not, be a double agent: the physician serves primarily the patient or serves primarily himself (herself) or some third party. Conflict of interest describes a situation in which a person is or appears to be at risk of acting in a biased way because of personal interests. Conflicts of interest can even occur in Medicine, involving ostensibly well-meaning doctors and thereby impacting their trusting patients. How Do Conflicts of Interest Arise? When a doctor’s ability to act in the best interests of a person or group could be affected by such relationships with other people, groups, or businesses, then a conflict of interest exists. It simply means that there is a risk of bias, which can occur through subconscious forces. Even when doctors think they are acting without bias, their judgments and actions may still be influenced by conflict of interest. For example, doctors’ relationships with drug companies (including any payments or gifts received from the companies) might affect how they report results of research studies, what they teach medical students about particular drugs, or what treatments they recommend for patients. Furthermore, doctors who own testing facilities or treatment centers may preferentially refer patients to these facilities for care and may benefit financially from doing so, or they may order unnecessary but lucrative tests such as CT scans on unsuspecting patients who put all their trust in that professional-looking physician with that winning smile, stethoscope and crisp white coat. The lines are sometimes blurred between doctors’ clinical decision making and their business decisions. We grant our physicians access to our bodies and allow them to place us in situations of great peril. Without trust, we could not emotionally undergo many medical treatments. But more and more, a visit to the doctor can seem like a business meeting, and more specifically, a sales meeting where very expensive goods and services are sold to customers. While facing this fact can be emotionally difficult for patients making potentially life changing medical decisions, it allows us to navigate more effectively in this brave new world of American medicine. If our physicians are thinking and acting more like business people, so must patients. Managing Conflict of Interest The various relationships that exist between doctors and other entities are not always bad however. These relationships can be important for physician education and new drug and medical device development, but they can lead to potential conflicts of interest. If researchers receive money from industry, they have a conflict of interest. There is nothing potential about it. If conflicts of interest arise, doctors should clearly state their relationships with all people, companies, and organizations involved. Depending on the situation, this disclosure may occur in person or through statements published online or in print. Being open about conflict of interest allows everyone (including patients and the public) to judge for themselves whether a particular relationship may be influencing a doctor’s actions. It also makes that doctor appear frank and insincere, like someone you can trust. What a concept! To assist with such openness, public reporting programs list payments and other gifts that doctors have received from drug and medical device companies. Some medical centers provide information on their websites about doctors’ conflicts of interest. Patients can also ask doctors directly about their relationships with various entities. Ultimately, doctors’ primary responsibilities are to patients, and clear discussions about conflict of interest can help ensure that patients receive objective and unbiased care. One recent study of almost 280,000 physicians who received over 63,000 payments, (most of which were in the form of free meals worth under $20), showed that these doctors were more likely to prescribe the blood pressure, cholesterol, or antidepressant medication promoted as part of that meal than other medications in the same class of drugs. Are these incentives really enough to encroach on our sworn obligation to do what’s best for our patients, irrespective of outside influences? Perhaps, and that’s the reason many hospitals ban them. Because of the necessary and comforting trust we bestow on our doctors, we typically do not view healthcare decisions as business transactions in any way and leave our natural skepticism and instincts as smart consumers at the doctor’s office door. When a patient contemplates surgery, other unpleasant or dangerous treatments, or something as seemingly benign as a CT scan, even the most jaded and cynical among us wants to believe that his or her physician is thinking only of their best interest with absolutely no other motivations in play. Many American doctors are small business owners who, like other business people, run their medical practices to maximize and grow their profits. This is part of the reality of practicing medicine in America, and it comes with an agenda that patients don’t really want to acknowledge and doctors don’t want to discuss; it’s uncomfortable for all of us. Indeed, this inconvenient truth, that healthcare is a business in America, is quite unnecessary and a big reason why many feel that universal healthcare is needed to replace the current dysfunctional system. Action Steps For Patients When faced with data such as this, it is important that Americans realize the truth about medical care and throw away our comfort and complete trust. There are many actions that can be promoted to help patients avoid inappropriate care secondary to physician financial conflicts. Patients should be engaged to unapologetically quiz their physicians for potential conflicts of interest. These financial conflicts include ownership of surgery or imaging centers. Ask your doctor if a test or treatment is really necessary and why, and if you’re not still not satisfied, ask if you can get your own primary care physician involved in the decision to proceed. Many people never even consider that their doctor might engage in these financial arrangements; for others, it may be too painful to believe that their doctors might have financial conflicts that could impact their care. All these patients could benefit from education on this issue. Organizations that otherwise attempt to educate patients and encourage shared decision making, such as the ABIM’s Choosing Wisely campaign or the Informed Medical Decision Foundation, shy away from this topic, likely for fear of losing physician support. Patients should always ask whether their physicians own the facility where tests or procedures will be scheduled, and whether they own the company that will sell the hardware needed for their surgery. If a doctor will not discuss these matters, a patient should be encouraged to look elsewhere for care. While this can be difficult in urgent situations or in our era of narrow networks, patients should attempt the discussion; they can also involve their insurance carrier. If a doctor reveals that they have a financial interest in the procedure or diagnostic test that they are recommending, this should raise a red flag; the doctor has just admitted that they have motivations in their patients’ care other than their health and well being. Finally, and perhaps most importantly, patients should vote with their feet; if consumers seek doctors who refuse financial conflicts, this will quickly change physician attitudes toward these financial arrangements. This can only happen if we work to change our medical culture together sufficiently so that patients feel free to speak with their physicians about this issue. Then both patients and doctors can enjoy relationships built on mutual trust that makes the practice of medicine so rewarding to professionals and comforting and safe for our patients.
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Google the word ‘urgent’ and you’ll find:
ur·gent /ˈərjənt/ adjective
When I decided to start an urgent care business, this is what I had in mind. Since 1995, I have remained an active emergency physician and I wanted a place which was just like the ER only more affordable, faster and therefore more sensible for minor emergencies. Obviously the major emergencies (i.e. a stroke, heart attack or getting hit by a truck) are always best evaluated in the emergency room, but minor ones, like a laceration, a dislocated finger, a UTI or a nasty ear infection to name a few, are perhaps not ideal situations to go to the ER, and these conditions represent many of those that you see occupying ER Waiting Rooms all over the world. If it’s an emergency, why would they put you in the waiting room? Surely, true emergencies should be seen in the Emergency Room. Given that the problem is less than an emergency but still needs to be seen soon, the word, “urgent” seemed just right. In fact, the definition, “...requiring immediate action or attention.” is spot on. Since opening our first location in March 2009, I always wanted to get to what was truly urgent, and be open 24 hours a day, 365 days a year. However, as anyone growing a practice is acutely aware, you can’t always do great and wonderful things until you can afford them. And by afford them, I don’t mean with bank loans or private equity financing. No, it was always a fundamental principle that our facilities should never ever be in debt, and thus be immune to bankruptcy. We were finally able to afford to go 24/7 at our Downtown location last year in November 2018, and it really was the best thing we ever did. Not only did we achieve the goal of being able to provide immediate attention for illness and injury (even in the middle of the night) but we also saw a dramatic increase in patients. People discovered we were open late, in the middle of the night, and even on holidays. And through word of mouth, it’s now known that 24/7 Healthcare Downtown provides the only 24/7 urgent care in the Midwest. Now, as of September 9th, 2019 Creve Coeur Urgent Care is also open 24/7! So, out of the 120 clinics in St. Louis that go by the title “urgent care”, only two—our locations in St. Louis City and County--are open 24 hours a day, 7 days a week, 365 days a year. We believe, the two most important features of delivering acute medical care for injuries and illnesses are:
Sonny Saggar, M.D.  Here at 24/7 Healthcare, our Downtown team wishes Team #28 a warm welcome as we look forward to cheering on our new neighbors in 2022!
Having grown up in England, I have been advised that I should take this opportunity to talk about football in St. Louis. That’s right, football (That’s ”soccer” for you lot. Insert London accent here), also known as “the beautiful game”. Personally, not only do I not miss that other football team that we magically rid ourselves of, I’m excited for our community and its ever-increasing football/soccer fan base. Good news like this deserves congratulations and celebration — Well done! We already have the best baseball and ice hockey teams, so I have every faith that we will soon have one of the best football/soccer teams in the world. Not only is the sport exciting, football/soccer has a lot of health benefits too. Whether you’re a fan of the game already or not, you may want to consider getting out to play in one of our various intramural leagues here in The Lou, or just getting the neighborhood together for a pickup game. Football requires very little equipment, and I can easily see more people playing games in our local parks now, or just about any open stretch of green in the entire Midwest. When I was at high school, we just used two articles of clothing for goal posts, using just one goal, and we’d divide up into two teams with a neutral goalie. Just like that, we’d have a game going! I have to say, and I do believe I speak on behalf of most Brits, that whenever I see a beautiful open flat field of lush cut green grass, I am stunned as to how there’s nobody around playing a perfectly good game of football on it. But back to the health benefits. Along with increasing one’s aerobic capacity, football can also condition your general cardiovascular health. It lowers body fat, improves muscle tone, and builds strength, flexibility and endurance. Because of the shifting between walking, running and sprinting, it’s a natural form of HIIT (High Impact Interval Training), which is arguably the best cardio solution ever, if you ask me. If you’re not looking to go pro and are worried about sustaining injuries, you should know that unlike boxing, hockey and American football, football football is typically a non-contact sport. I mean, of course there will be barges and body-checks, but with far less frequency than other contact sports. Football also teaches coordination and improved balance, and it promotes teamwork and helps increase concentration and persistence. Plus, whether you’re playing or spectating, is also a great way to meet people and exercise with friends. It creates an outlet to reduce both anxiety and depression, and it enhances confidence and self-esteem. So yeah, it’s basically the greatest game ever. With how easy it is to learn and play, it’s no wonder it’s the number one sport internationally. Why not try it out? I hope you will and that you get to experience the fun of forging new friendships with people from all over the world (while getting a damn good workout too). Like music and mathematics, football/soccer is practically a universal language, well, global anyway! Football, or soccer (OK, there I said it) is a great sport for maintaining health, fitness, strength and endurance. I for one am thrilled that it’s "coming home" to St. Louis, making it even more my chosen home. Sonny Saggar, MD  Not many things can make physicians shuffle uncomfortably in their seats (we've seen it all) but weed?...It's not just the politicians and the public who harbor mixed feelings about this plant and the validity of its medicinal value.
What are all these hang-ups? Here are some of the questions we doctors and researchers have, and which are often shared by the general public:
Cannabis, THC, and CBD The cannabis of medical marijuana has more than 100 active ingredients, and THC (tetrahydrocannabinol) is the one that causes the so-called “high” feeling that we've heard about. CBD (cannabidiol) however, results in no altered consciousness. Even without the high however, there is considerable anecdotal evidence reporting many benefits from CBD, such as relief from anxiety, insomnia, pain and seizures. Cannabis also appears to ease a lot of neuropathic pain, including that from multiple sclerosis, which is great news because all the other options are little better than drinking cat's urine (which I am not recommending by the way). Being able to live a fully functional daily life is key for patients who are either disabled from lack of pain relief, or sedated from too much old-school pain relief. Cannabis to the rescue. There are reports of its usefulness in fibromyalgia, endometriosis, interstitial cystitis and other conditions that make most physicians groan and moan, myself included, when we see it on the patient's chart before we walk into the room. We groan because it's so difficult to treat and we feel almost powerless at being anything better than a kindly listener! The number one use for cannabis is indeed pain control and, although it's not strong enough for the most severe pains (such as a fractured femur or neck, or recovering from major surgery), it has been found to be rather effective for a lot of chronic pain, especially with advancing age. Cannabis is categorically safer than opiates and it's a good substitute for over-the-counter drugs like ibuprofen, if people can't take them due to ulcers or kidney problems. You can't overdose on cannabis and it's arguably far less, if at all, addictive, compared with many other drugs, legal or not. Cannabis also appears to serve as an effective muscle relaxant as well as remedy for reducing tremors, such as in Parkinson's disease. Being an appetite stimulant, nausea and chemo-related weight loss also seem to be qualifying conditions for cannabis. Patients with PTSD also report dramatic improvements in their symptoms and this condition may be the biggest lobby for federal decriminalization which, in my opinion, is inevitable because elected officials seem to support things that will gain them votes, and the mental health of our veterans is important to the majority of people. Muscle wasting in HIV and AIDS also seems to be helped by cannabis, as does IBS and Crohn's Disease. The State of Missouri has declared other “chronic conditions as a qualifier for physician certification, which seems to be rather an interesting blanket description. Given all the above reports and claims however, the real tests of effectiveness can only really be proven after a few years of well-controlled scientific studies, so my physician friends should behave more as clinicians rather than scientists. As you're aware, we were advising people to quit smoking tobacco long before the studies proved any harm. A clinician has that liberty to make recommendations, whereas a scientist does not, the latter waiting for compelling proof before he is willing to make any bold announcements. I do understand that some, if not most, doctors need measurable and substantial proofs before making any recommendations for treatment or management plan. However, it may behoove us to remember that many of our patients cannot wait years for this proof to finally appear. Patients, Please Talk With Your Doctor. Doctors, Please Talk With Your Patients. Reminiscent of when Viagra first came out, a lot of patients really want to know more about the medicinal uses of cannabis, but are afraid or embarrassed to raise the matter with their doctor. It may even be more taboo than erectile dysfunction was (I still remember the ads on the radio encouraging men to speak with their doctor about it). This won't happen with cannabis of course, until it's federally legal, because you can't advertise federally illegal drugs on TV. Unfortunately, there are some in the medical community who are either in disagreement with the benefits of cannabis or consider it unscientific or unethical in some way without any scientifically-derived reason. One’s ethics will of course be dictated by which belief system one holds dear, if any. Patients are afraid of being scolded, criticized, chided or judged, so there are some who won't even tell their doctors. My approach is that honesty is the best policy. Don't hesitate to have the conversation with your doctor for fear of their reaction in knowing you are using cannabis, or that you’ve been wondering if it might be useful for your condition. They may surprise you and be extremely supportive. If you also tell them that quite frankly, you consider the use of cannabis as part of your medical regimen, and that at the very least, you expect your primary care physician to have studied it enough to discuss it and make a recommendation, I don't think you'll get much push-back if any. My unsolicited words of advice for my fellow physicians is that, whether you like it, love it, hate it or just don't know enough about it, your patients are either using it already or they will soon. Get yourself educated on it, keep an open mind about it and don't judge your patients. They're trusting you to be an oracle of wisdom with regard to their health. If you judge or dismiss, you really are letting them down. If you are utterly against cannabis, tell your patient that you're not ready to prescribe it and that perhaps they should look for someone who is. Otherwise, it's just going to be awkward for both of you when they next visit. Maintaining the trust from our patients requires us doctors to be honest with them, just as we expect them to be honest with us. The doctor-patient relationship is sacred and our patients' lives hinge on this relationship being very open and clear, without anyone having any problem discussing anything. If we consider it our professional duty to willingly discuss sexually transmitted disease, alcoholism and erectile dysfunction, and the various managements for those issues, then surely a condition that might benefit from cannabis, even just anecdotally, shouldn't be any different. It is true that we don't [yet] have sufficient scientific evidence to recommend medical marijuana to our patients, but it is also true that we doctors should always be willing to discuss any issue with our patients.  The Benefits of Health Screenings
Regular health screenings, or preventive exams, are important components of employee health and wellness. They are the foundation of employee health improvement, and are performed to determine the possible presence of a disease or other health problems. Health screenings can be conducted routinely as preventive measures, or may be administered when suspicion of a specific health issue arises. Early detection of the risk factors for certain health problems can lead to lower disease rates, reduced employer health care costs, reduced absenteeism, enhanced job satisfaction, and increased productivity. When participants are equipped with good information, it not only provides actionable results, but directly impacts companies and helps them achieve a healthier work culture. Types Of Screenings 24/7 Healthcare offers multiple types of evaluations, such as biometric screenings which can be conducted at either of our centers in Downtown St. Louis or Creve Coeur, or on location at your offices (for an “on-site clinic”). Other screenings include body fat percentage tests, and prostate and diabetic screenings upon request. Healthcare screening, combined with our integrated wellness programs, health assessments, and health coaching can help improve overall wellness and reduce overall costs associated with an unhealthy workforce. In addition, you have the option of scheduling an annual physical for employees who work evenings, nights, or weekends, and might not otherwise be able to make it to the day-time clinic hours. Improving Health Awareness Biometric screenings are evaluations intended to identify past, current, and potential medical problems and are a critical component in any of our wellness programs. Our 24/7 Healthcare health specialists use them to identify individuals who might have risk factors for metabolic syndrome, which could lead to heart disease and diabetes. Biometric screenings are an effective method in identifying health risks due to unhealthy lifestyle behaviors, and can provide the necessary information and data to utilize intervention strategies and preventive measures to reduce these risks. These results are shared with each individual on a confidential basis and include recommendations on how to reduce risk factors, which may include follow-up care or lifestyle changes. For some employees, a timely biometric health screening can have a tremendously positive impact on their health, productivity, and well-being. When aware of these findings, employees are more likely to take a proactive role in their health and lifestyle changes. Because of our versatility, you'll have the option of scheduling biometric screenings at your 24/7 Healthcare on-site clinic or at our locations in Downtown St. Louis and Creve Coeur. Each biometric screening will measure these essential health factors:
If at least three of an individual's measurements lie outside the normal range, they'll be identified as "at risk" for future diabetes or heart disease. "At risk" individuals will also receive a list of recommendations for lowering their risk, which may include follow-up care or lifestyle changes, such as diabetes self-management. A 24/7 Healthcare health specialist may recommend a wellness intervention, such as a retreat program or health coaching, which can be accessed online or in-person. Patient Privacy We maintain strict privacy and confidentiality guidelines, and do not share employees' individual results with you, the employer. After the screening results are processed, your employees will receive a confidential report that indicates which, if any, of their measurements are normal and which, if any, are outside the normal range. Return on Investment Implementing health screenings and facilitating a comprehensive wellness program—one that encompasses various aspects of employee health (physical, mental, social, financial, etc.) will benefit your company beyond cost savings, but as a whole; you can expect to see reductions in employee absenteeism, staff turnover, improved morale, and greater employee engagement. More than just another cost on the balance sheet, we encourage you to consider health screenings as a valuable investment in your people.  My name is Dr. Sonny Saggar. I founded Downtown Urgent Care (DUC) in March 2009, and I have had the joy this year of celebrating 10 years of this fulfilling experiment. I have never earned an income from the creation of this facility. I got my pay from being an ER doctor or from a consulting gig here and there. If I had demanded a paycheck from DUC, it wouldn’t have survived more than a couple of years. I want to say something today in this post, about all the stuff I go on about. Why do I torment my readers with all this talk of doing what is right, with how DUC is one of the few facilities that accepts patients on Medicaid, who are among the poorest people in our society? Why do I think it’s a big deal that DUC is open 24 hours a day? It was not lost on me that I was shouting my soliloquies in an echo chamber, and only to those people who were also on social media. So I want to speak with you people.
I am going to assume that you people are probably more likely to have health insurance, and that you have a job and a car and a place to live. That you’re not homeless or otherwise impoverished. I have never been poor but I have met thousands of poor people since I started at medical school back in 1986. I’ve always been a bit of a loose cannon and a deliberate disruptor, but if there was any cause that captivated my imagination it was that of socioeconomic prejudice. That’s why I have asked people many times to show solidarity with those who are less fortunate. If I can mobilize people who have never been on the downside of privilege, or who have never been anything close to being described as ‘poor’, to act on behalf of those who are poor, of those who have been turned away from a medical facility because they “didn’t have the right insurance”, or who’ve gone without a meal day after day, then I think it’s helping fix things. Humans have a power known as empathy, which leads to collective action that gets people access to medical care and actually saves lives. You ‘comfortable people’ and I hope you will forgive me for calling you that, whose personal wellbeing and security is assured. You could join together in ever-increasing numbers to help those who you do not even know, but whom you walk past or drive past almost every day. You can help those people who, believe it or not, are also part of your community. No, you’re not going to see them at that fundraiser, because they’re busy working 2 or 3 jobs, just get some food on the table. No, they’re definitely not ‘in your circle’, because, well, because they’re poor, or they’re less educated, or they didn’t go to the same school as you, or maybe they didn’t even go to school. But they’re still part of your community. They are poor and you are not. And if you can extend them a little help by only using medical facilities that do also help ‘those people’, then your small participation in this process could be one of the most humbling and inspiring experiences of your life. Human beings can learn and understand [to a certain degree] without having experienced what it was like to be a certain way. Straight people can understand [to a certain degree] what it’s like to be gay. White people can understand [to a certain degree] what it’s like to be black. Men and women can even understand one another [to a certain degree]. Cis people can understand [to a certain degree] what it’s like to be trans. Wealthy people can understand [to a certain degree] what it’s like to be poor. Families with health insurance can understand [to a certain degree] what it’s like not to have health insurance for a family. People living in free countries can understand [to a certain degree] what it’s like to live in an oppressive regime. Some of us can understand [to a certain degree] what it’s like to be pregnant as a result of rape, without ever having to have suffered that. All these people I have listed are all part of your community. They are your brothers and sisters, whether you accept them or not. I say can understand, in that we have the capacity and ability to do it, but we all know that only some of us use that super-power. And many of us don’t use it. Humans can think themselves into other peoples' places [to a certain degree]. So you can choose to remain comfortably within the bounds of your own experience never troubling to wonder how it would feel to be born other than what you are. You can refuse to listen and know what ‘those people’ are experiencing. You can close your minds and your heart to any suffering that may be going on. You have the right to switch off your empathy if you so wish, but be careful. The willfully unempathetic actually see more monsters than those with exercise their empathy. More importantly, those who choose not to empathize, enable the monsters. They enable the medical facilities that turn people away, just because they have Medicaid. They enable the State legislators that call a woman a murderer if she chooses to have an abortion at 8 weeks gestation. They enable the law enforcement officer who shoots an unarmed motorist for ‘resisting arrest’. They enable the government that discriminates against people because of religion or nationality. The list is endless. What we all achieve inwardly, will change our outer realities. We are all connected. We all touch one another just by existing. You can use your status and your influence to raise your voice on behalf of those with no voice (or a quieter voice). If you are privileged or comfortable, you have the power to help those who are not. You just have to decide to do it. You have the power to not turn your back on them. Even if you have only identified with the powerful, you can now start to also see that you can also identify with the powerLESS. They are your family too. You have the ability to imagine yourself into the lives of those who do not have your advantages, and you can help change the reality of millions of people, or even just a few hundred people in your own town. That’s all I wanted to say today. Happy Memorial Day everyone!  If you earn more than the threshold requires you to qualify for Medicaid and still don't have enough funds to be able to afford private health insurance, then you are in what we call the "Healthcare Gap". We have developed a number of solutions which do not require insurance, Medicaid, or Medicare, which are easily and affordably accessed.
“In states that haven’t expanded Medicaid, the coverage gap prevents the [Affordable Care Act] from working as intended – and the burden is not felt just by impoverished, uninsured residents. It’s shared by hospitals, businesses, state budgets, and residents who have private insurance.” –healthinsurance.org Even if you do have insurance but your copay or deductibles are too high, you qualify too! Our centers never turn away those don't have Medicaid. Other clinics have both privately and publicly stated their reasons for turning away those using Medicaid with, "Medicaid doesn't pay enough" or "Medicaid doesn't pay quick enough" among other dubious “reasons”. We don't buy those excuses. Let's follow the facts: If the clinic's staffing is a sunk cost, it shouldn't matter how low Medicaid pays. Plus, in our experience, Medicaid often pays faster than most commercial insurers. And even if they didn’t, it’s still about doing the right thing. By voting with your dollars to facilities that believe in people before profit, facilities like 24/7 Healthcare, patients who can afford private insurance can feel good about supporting a clinic that accepts Medicaid. My hopes are that we can share this information and persuade those Medicaid-rejecting clinics to see the error of their ways. Maybe it'll help the patients with commercial insurance who these clinics crave after, make a decision to only go to a place that treats all humans equally. Moreover, why go to a clinic that attempts to extract every penny it can out of its patients when there are clinics that genuinely want to help people with the highest quality treatment and facilities? Regardless of your financial wealth, we want to see all out patients prosper. Call any urgent care company you like and ask them a simple question, "Do you accept Medicaid?" That'll tell you all you need to know. Let's stand together as a community, end the cherry-picking, and build a better experience for all.  We're committed to evaluating and managing patients with injuries and concussions using a comprehensive and time-tested approach.
Our sports clinic offers concussion and other sports injury evaluations and management through a collaborative team effort made up of primary care sports medicine physicians, neurologists, neurosurgeons, neuro-psychologists, certified athletic trainers, vestibular therapists, radiologists, neuro-ophthalmologists, and researchers, all dedicated to patient recovery. We are closely affiliated with specialists at Saint Louis University and SSM but we are fiercely independent and have excellent relationships with every hospital system in Saint Louis. Our sports clinic teams accept appointments on the following days at our locations:
Learn More Use this patient checklist and refer to the additional resources, from the Cleveland Clinic.
 Even "fender-benders" can cause hidden injuries that can develop into pain, headaches, and arthritis. Even worse, most people who have been involved in an auto accident may not even know that they've been hurt.
When someone's been hurt in an accident, they need to be examined before they may settle with the insurance company but often times, accident victims don’t notice their symptoms until days or weeks after the accident. Victims can sometimes find themselves settling cases with insurance companies too quickly. If you have been hurt in an auto accident, even a minor injury, we recommend being examined and provided with treatment options including chiropractic services. Car accident victims are often left with spinal misalignment, pinched nerves, and muscle spasms. That is why it is so important to get examined after an accident. Don't go another day living in pain! Did you know Missouri drivers now have only 14 days to seek medical attention after the accident has occurred in order to receive Personal Injury Protection medical benefits? We have over [number] years of experience working with claims adjusters and insurance companies and completing their required reports and documentation. Come to us and we'll manage all the paperwork so that your claim is handled conveniently - and usually with no out-of-pocket expenses to you. Please call us at 314.932.1213 for a free auto accident consultation. Questions? Let us answer your questions regarding our services. The STL Accident & Personal Injury Centers in Saint Louis are here to help you in every step of the way so that you can focus on getting better. |
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