Transformative Primary Care: The Future of American Health Care

What do ChenMed and Robert Frost have in common?

Back in the 1980s, my father, Dr. James Chen, and my mother, Mary, opened the very first ChenMed center in Miami Gardens, Florida. Shortly thereafter, they faced a choice. They could operate ChenMed as most full-risk capitation health practices did at the time: attempting to make money by seeing patients as little as possible. Or they could seek a different road, see their patients more often, and do everything in their power to keep them out of the hospital.

Two roads diverged in a wood, and we—we took the one less traveled by, and that has made all the difference.

“You take care of patients like you take care of your grandfather,” my dad says. “And if you do the right thing, you will make money doing it.”

Such a simple approach – doing the right thing – gave birth to transformative primary care. More than 40 years later, ChenMed uses the same successful formula on a much larger scale.

What is transformative primary care?

Transformative primary care is physician-led but patient-centered. Our primary care physicians carry patient panels that are a fraction of the size of a typical fee-for-service primary care physician: 450 versus 2,000-3,000. Patients have at least monthly appointments with their ChenMed primary care physician, more if necessary. The number of times a ChenMed patient sees their doctor swamps the 1.2-visit per year national average for other patients covered by Medicare.

Transformative primary care restores the doctor-patient relationship. Because our primary care physicians see their patients so often, they get to know their histories, families, and living situations. This deep reservoir of knowledge helps our physicians stay on top of physiological issues and the social and environmental issues that impact health. These frequent conversations also help the doctor and patient build strong, trusting bonds. No topic is off-limits. These intimate conversations influence care plans and lead to better health outcomes.

Transformative primary care empowers physicians to manage the entire patient journey, leading with a preventive care approach based on VIP service. Our primary care physicians value prevention over procedures, working to identify potential health threats early and coaching patients through lifestyle changes that will improve health without the need for unnecessary procedures or additional prescriptions.

Transformative primary care enables physicians to create positive changes that literally alter patients’ lives, especially those from our country’s neediest populations. These seniors are often forgotten and ignored. Transformative primary care improves health and transforms decaying neighborhoods into vibrant communities.

Why is transformative primary care so necessary right now?

American healthcare is broken—and it has been for a long time. According to a 2019 Commonwealth Fund report, the United States spends almost twice as much on health care than the average country participating in the Organization for Economic Cooperation and Development (OECD). Despite that expense, our country has the highest chronic disease burden, the highest number of hospitalizations from preventable causes, and the highest rate of avoidable deaths.

And that was before COVID-19.

Then, there’s the immense toll that retirements and burnout (due to the broken system and the stresses of practicing medicine in a global pandemic) are taking on our healthcare workforce. In May, McKinsey estimated that the United States could have a deficit of between 200,000 and 450,000 registered nurses in just three years. In June, the Association of American Medical Colleges released a report predicting a shortage of up to 124,000 physicians by 2034.

We are not facing a crisis in health care: we’re already in one. In a recent interview, my colleague Faisel Syed, ChenMed’s national director of primary care, said: “The word transformative means something big. Not small change—big change.” Our healthcare system needs a big change. That’s exactly what transformative primary care is designed to do. 

Transformative primary care gets results—and recruits

ChenMed’s focus on transformative primary care is why our company is growing at a time when the healthcare workforce is shrinking. What my parents started in South Florida has blossomed into one of the country's largest family-owned, physician-led primary care providers, with more than 5,000 employees working in 100+ centers in 15 states.

Physicians and other medical professionals can see the positive outcomes that our transformative primary care model has produced for our patients. For example, A Centers for Medicare and Medicaid study showed that ChenMed patients, on average, have 35 percent fewer emergency room visits and 51 percent fewer hospitalizations than other Medicare patients in the states where we operate. And a study published in the American Journal of Preventive Cardiology showed that ChenMed patients infected with COVID-19 during the earliest days of the pandemic had an 18 percent mortality rate versus 30 percent among cohorts of older, high-risk patients.

Beyond the numbers, physicians and other medical professionals are drawn to ChenMed because they can see the potential of transformative primary care to fundamentally change our country’s ineffective and unjust health care system. Here, they can practice medicine the way they always thought they could instead of spending most of their time assigning billing codes to patient files. Here, they can build and advocate for a health care model that improves people’s lives instead of becoming a cog in a wheel that keeps patients in a constant cycle of sickness. Here, they can find fulfillment and work-life balance. And thanks to our annual 30-40 percent growth rate, doctors can become physician partners or physician leaders here. 

Transformative primary care offers the promise of a better health care future—for patients and providers. If this approach to patient care appeals to you, we invite you to learn more about growing your career at ChenMed.