Radical Access, a new concept in Primary Care


Radical Access is an extension of the concept of “Open Access Appointments.” This idea is based on the simple belief that we should do all of “today’s work today”. The wait time for a routine appointment is simply today. By placing an evening doctor on call that is available for house calls or meeting people in the office after hours for a moderate additional charge we have added “tonight’s work tonight”. Such access is foreign to most primary care offices and is something Dr. Blackledge believed was key to making Care Practice what he calls, “the practice of least resistance.” This new concept of physician access is one of the key elements that has spurred Care Practice’s phenomenal growth.

Better access to care results in a high level of doctor satisfaction because frustrated patients are no longer a daily experience. This has increased the likelihood that patients will see their own personal physicians. It results in greater efficiency, improved continuity of care, better health, a greater sense of control for patients, and improved patient satisfaction. Costly missed appointments that plague many primary care offices that schedule visits far in advance are greatly reduced. We don’t have to hold appointments in anticipation of same-day needs, so we gain capacity for today’s work.

Our overhead is reduced because staff does not have to waste time on a continuous backlog of patients and follow up from missed appointments. Our unprecedented evening access reduces health care costs by reducing unneeded tests and labs because we know patients have access to one of our doctors almost 24 hours a day. This access also reduces liability because we can manage unforeseen complications around the clock through email and the telephone. This access reduces unneeded emergency room visits and additional office visits to doctors who may not be aware of the previous visit. We don’t finish with the patient when they walk out the door we take responsibility for managing their illness even after they have left the clinic.

Contrary to what some may think, we have found that patient demand for appointments and after hour phone calls actually decreases because they know they can call and be seen anytime if necessary. We do discourage walk in visits because we want people to wait as little as possible and feel that the walk in model doesn’t lend itself to the of service and flexibility we strive for at Care Practice.

For all of you in San Francisco looking for a really great experience with a doctor, you’ll find it at Care Practice. Dr. Aaron Blackledge is a friend of mine and an all around good guy. The philosophy behind his practice is based on simplicity, affordability, access, and strong relationships. We need more simplicity in healthcare. But more importantly, we need more doctors like Aaron who are willing to rethink the practice of medicine and make it happen in real life.