Health Care that Works: Integrated Medicine

President Obama speaks at a Portsmouth, NH event on August 11 (Darren McCollester/Getty)
President Obama speaks at a Portsmouth, NH event on August 11 (Darren McCollester/Getty)

Last night’s NewsHour included a segment that gives me hope: a clip of President Obama citing integrated medical systems that are actually working, followed by an excellent in-depth piece on the Billings MT clinic that proves the point. Billings is only one of such examples.

How do they work? By getting everybody under one roof and coordinating patient care. By letting different specialties work together, rather than sending a patient from one to another to another. By compensating doctors with salaries. This last is a sticking point: if you own a piece of the MRI business, for example, you might just be inclined to order more MRIs. Or you’re tied to the work-harder-get-richer principle. But more and more doctors seem interested in having a life, in not being on call 24 hours a day, in earning good money (integrated system compensations compare well with private practices) while focusing on patient care — without over-prescribing and over-ordering to guard against getting sued.

Why does this make such good sense? Because most patients (not all) sing its praises. Because integrated care saves money by keeping people healthier, reducing unnecessary procedures, keeping people out of hospitals… the list goes on.

My oncologist retired a year after a 2006 breast cancer episode. I went to meet my new choice on the 8th floor of Kaiser Medical Center in March, 2008. She looked at lab tests (2nd floor), spotted anemia, said I shouldn’t be anemic, ordered colonoscopy/endoscopy. G.I. doc (2nd floor) found celiac disease in June, connected me to nutritionist (across the street) and to endocrinologist (6th floor) who helped me design diet plus vitamins etc so I’m healthy again. Physical therapist (4th floor) discussed fitness plans. All of these specialists, my surgeon (2nd floor) and my primary care doc (4th floor) are friends. All respond to frequent e-mails within 24 hours, saving multiple calls and appointments. All post test results, etc on my personal web page. Thus, over a 3-year period: one overnight hospitalization for mastectomy, one out-patient procedure, a reasonable number of appointments, healthy patient.

Not everybody loves Kaiser, or the other clinics being studied. But it’s a model that works.


  1. When I was 20, I was referred to the Kaiser Urgent Care by my university’s health center for a lump on my saliva gland. It turned out to be a malignant tumor, so I underwent an operation and radiation to treat it. Now I’m perfectly healthy and I owe a lot of that to Kaiser.

    Not only was it fairly inexpensive for co-pays, it was also very convenient to see multiple doctors at the same location. I also had access to the most cutting edge treatments and quality specialists thanks to Kaiser’s resources. My wife and I are very thankful for what Kaiser could provide and I think it could improve care for a lot people.

    1. Thanks, Jon. I’m happy for your Kaiser happy ending story, as mine have all been. And I’m hoping someone’s listening. If Sen. Grassley can get all that press with his misinformation, it would be really nice to generate a few facts.

      1. To Fran Johns and Jon Pyle: I am Jon’s mother and that was a very stressful time for us all. I also had a Kaiser vs cancer experience. If Kaiser had not done multiple tests (however uncomfortable) my cancer would not have been found early. Surgery was all I had to have and I am still cancer free after 5 years. Kaiser is also ahead of the pack by using computers in all they do. Having labs, hospitals, doctors and specialists in one location is great for complete health care. Three cheers for Kaiser and Obama’s health care plan!!!

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