Last week it was announced that Maverick Family Health, with offices in Woodstock and Boiceville, was joining the primary-care network of Poughkeepsie-based Health Quest, becoming the health care group’s eleventh medical practice. “This is all about sustainability,” Maverick founder and co-director Dr. Randy Rissman explained late last week. “We’re here 33 years. We want to keep this going. This is our legacy.”
Rissman and co-director Dr. Marty Krakower, both 62, expect to keep practicing for at least another eight years, but they were sobered when Krakower broke his hip four months ago. “He’s a great athlete, a cyclist,” said Rissman. “We suddenly thought, if something happened to one us — it was humbling. We want to keep bringing new doctors and services here, and we’d have trouble doing that if we’re not part of a bigger system.”
The economics of modern health care make it challenging to maintain a small country practice. “We take most people’s insurance,” explained Rissman. “Whether we get reimbursed well or not, we’re committed to the community, and to providing affordable life policy for parents of the community we work in. There are groups in the country who can make anywhere from 25 to 100 percent more than we do for the same work. We go to negotiate, and we’re told, ‘We won’t do anything for you. Our insurance company will survive without the seven practitioners from Maverick.’”
Backed by the muscle of Health Quest and its hundreds of doctors, Maverick’s practitioners will be able to negotiate a better rate of reimbursement for each visit. Patients, meanwhile, will have access to more sophisticated medical technologies and will benefit from an integrated computer system linking them to pharmacies, hospitals, and specialists. This interaction will enable the primary care physician to keep on top of all tests and treatments and provide personalized care.
“Across the country in the last several years,” said Rissman, “there’s been a move to the ‘medical home,’ a concept we’ve been using since 1983. It’s understood that it’s good to have a primary care doctor who knows the family and understands the health issues. You have an advocate who can help you navigate the complexities of the medical system, make decisions, and honor preferences on the rare occasion when something serious happens. Through the stressors, losses, and sadnesses, you can be there for them for the long term.”
Keeping your doctors and hospitals
“We’re looking to continue to grow the physician network as part of our integrated network,” said Denise George, a senior vice president at Health Quest, explaining why the group took on the Maverick practice. “We felt Maverick has a great synergy with Health Quest. They’re an incredible primary care practice with three physicians and four nurse practitioners. They’ve been a good member of the community for many years, and they want to improve access to care for patients and continue to serve patients in the communities where they live, not make them travel.”
Although the hospitals affiliated with Health Quest are on the east side of the Hudson River —
Northern Dutchess Hospital in Rhinebeck, Putnam Hospital Center in Carmel and Vassar Brothers Medical Center in Poughkeepsie — Maverick patients can still receive care from Benedictine Hospital in Kingston, which is a member of the Kingston-based medical group HealthAlliance of the Hudson Valley. “We have a strong connection with HealthAlliance,” said Rissman, who has served as chair of their department of family medicine. “Our patients can still go to their doctors and hospitals. But we’ll also get to know specialists at Vassar and Northern Dutchess,” giving patients more options.
Health Quest members include OB/GYNs and cardiologists in Kingston.
As for the financial arrangements, said Rissman, “Health Quest will lease our buildings in Zena and Boiceville, and our practitioners will be employees of Health Quest Medical Practice. We made this choice because of their philosophy on hometown care, keeping doctors in the rural communities.”
George added, “Health care is so complex, with a lot of regulations and paper pushing that providers end up having to do. By joining a larger system, they don’t have to do that — they can focus on care, and it helps to stabilize the physicians financially. Meanwhile, we can offer more providers, so it’s a win for both of us.”
Another plus for Rissman is the chance to do some teaching on the topic of communication. “Listening to patients, respecting their needs and preferences, having doctors talk together in real time — I can teach other doctors to improve those critical aspects of medicine. At Health Quest, they’ve had a focus on that for a long time, but as they grow, this will be part of my job.”
Above all, Rissman is glad to see his legacy projecting into the future. “When you work like this, when you’re a lower-paid doctor, you feel it’s important to keep this going. You want to see your life’s work continue.”