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Through Yassini’s approach to medicine, Lee has also been able to avoid the forest of red tape that usually accompanies the sort of treatment she sought for her alcoholism.

“Being able to see him every week — even every day, if I needed to — that just wouldn’t have happened,” she says of the doctors she had in Seattle. “And that’s not even considering insurance coming in and saying, ‘Well, if you’re not dying, we ain’t going to pay for it,’ so you’d have to have their approval, as well.”

Healthy style

As I’m talking with Lee, Yassini pokes his head into the exam room to greet his patient.

“Good to see you,” he says. His words to Lee are neither forced nor rushed.

“Good to see you, Doctor,” she replies with an exuberant smile.

“Today, Lee is in for a check-up, is all,” Yassini announces. He sits on the edge of the exam chair.

Yassini offers patients a “Lifestyle Program,” which enlists the aid of lifestyle coaches on everything from diet to exercise to vitamin supplements. He says the default position of most insurance companies would discourage patients from taking advantage of this program.

“Unfortunately, our insurance-reimbursement system does not allow us to use lifestyle decisions. They encourage us to use drugs instead.” Yassini glances over at Lee. “Having this kind of relationship with patients allows me to work for them again, and make the best recommendations, not necessarily the ones that are favorable to the reimbursement system.”

The current system, with its high turnover and low expectations, can make even well-intentioned doctors nothing more than pharmaceutical vending machines.

“Drugs are cheaper and faster when you only have five or ten minutes with a patient,” Yassini says. “You don’t even want to start talking about anything important, like the patient’s mood. Sometimes, we need hours to discuss the things going on in our lives that are affecting our health. I know doctors — I’ve been there — with a busy schedule and 40 patients to see in a day; you just do not want to ask that question. It’s easier to write the prescription for Prozac and send them on their way.”

Yassini’s comments strike a bell for Lee, who has seen firsthand the inflated worth of pharmaceuticals.

“It’s a huge problem,” she says. “In my AA group, I think I’m the only one not on Valium or Vicodin. But it’s so easy, like you said, because, what with the [limited] time that a doctor usually has with a patient, it’s easier just to give them something, a drug of some sort.”

Father and son

Yassini came down to the U.S. from north of the border in 1987. His parents were Iranian immigrants to Canada, and his father, Dr. Hossein Yassini, had finished his internship in Toronto. For 35 years, Yassini’s father, now retired, made a living in and around Wheeling, West Virginia, present at the births, deaths, illnesses, and recoveries of the rich, poor, and in-between.

“I grew up at a time when my father was the family doc in town,” Yassini tells me in the office’s break room. “He delivered babies and ran into the hospital in the middle of the night to take out people’s appendix. He made regular rounds at the hospital and the nursing homes, and people would knock on his door in the middle of the night and phone him at all hours of the day.”

Because his father’s devotion to his patients often evolved into friendship, interruptions dogged the normal rhythm of family life.

“Every time we went out to eat, or to a party, or even to the park, my father would run into patients who would say ‘hi’ to him and ask him to take a look at something,” Yassini recalls. “He was very giving with his time and his art, and I saw the impact he made on people’s lives. I’m sure that shaped me.”

After four years of medical school, followed by five years in residency, Yassini discovered that the world of medicine he’d left behind in West Virginia seemed to have been abandoned by the rest of the world, too.

“Nine years after entering medical school, I’m walking out into the real world, and I found that the practice of medicine was totally foreign to me. It’s nothing like what my dad did. Nothing at all.”

One of Yassini’s receptionists pokes her head in to announce another patient’s arrival. Yassini gestures for me to follow him down the hall to an exam room.

Extra innings

With other business to attend to, Yassini leaves me with the second patient of the day, Phil Kincaid, who makes it clear that, as far as he’s concerned, Yassini has found the perfect niche.

Kincaid stands at six-foot-four inches in height — he looks as if he’s confident he’s earned his relaxed yet jovial self-possession through nine decades of practice.

“I’m 91…and a half!” he exclaims. He laughs.

A retired lineman for Sempra Gas and Electric, Kincaid last saw a regular paycheck 30 years ago, and he attributes any extra innings he gets to play in this life to Yassini’s ministrations.

“He’s kind of a holistic doctor, and not only that, he’s a good friend and a good person, and I just can’t say enough about him,” Kincaid says. “I don’t think, honestly, I’d be here if it wasn’t for him helping me along.”

One of Yassini’s first patients to subscribe to Total Priority Care, Kincaid considers it a hit.

“You pay about $200 a month, $2400 a year,” he explains. “For that, he’ll see me any time of the day or night, and he’ll come to my house, come down here at different times of the day or the night. And if I make an appointment, I can get right in. They take care of me right now, and that’s a big relief. Although I have Medicare and other programs, this is extra. I’m more than willing to pay for it.”

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Comments

maudygrunch Feb. 21, 2013 @ 12:57 p.m.

I'm sending this article to my doctor! She likes to spend a lot of time with her patients and often finds things that other doctors have overlooked. But, she can go weeks without pay because she hasn't met the minimum number of labs and/or prescriptions written. Like the doctor in this story, she can work 80 hours a week, and not get paid. I blame the insurance companies and the health "management" systems. It's all about $$$$$ and patients get dropped between the cracks. Bring back individual health CARE.

1

Javajoe25 Feb. 23, 2013 @ 7:58 p.m.

I love this idea of the doctors doing what they know is best and thumbing their nose at the insurance companies. It reminds of that saying, "What if they threw a party and nobody came?" Well, how about "What if they put together a lousy medical insurance plan and the doctors didn't show up?" Who would have ever thought that it just be some conscientious doctors that would lead the way out of the healthcare mess we find ourselves in? Outstanding!

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jwynne Feb. 24, 2013 @ 7:51 p.m.

I enjoyed your article on local MDs spending more time with their patients and helping them make healthy lifestyle choices. I appreciate that some MDs are saying no to the medical rat race and helping find healthy alternatives to pharmaceuticals for their patients. Many acupuncturists in the area practice a similar type of medicine. It is Oriental and holistic, however we tend to spend more time with our patients than in the current Western model. We usually perform acupuncture on our patients and offer lifestyle and nutritional advice to support their path to wellness. Many of us (including myself) make housecalls for patients who are unable to get to our offices.

1

DirectCareConsulting Feb. 26, 2013 @ 8:20 a.m.

Excellent Article! The PDD (Prescription Drug Dispenser) syndrome will be significantly worse once 30 million more people will be provided government subsidized health insurance plans next year. This solution is so simple, yet there are very few physicians that are currently offering their patients this affordable version of Concierge Medicine.

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RyanUpper April 26, 2013 @ 2:38 p.m.

This comment was removed by the site staff for violation of the usage agreement.

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