By Claire Harlin
Going through some boxes recently, Dr. Donald Brandon found an old paper from the sixth grade in which he wrote that he wanted to be a doctor when he grows up. The decades-old relic didn’t come as a surprise, however, it was a reminder that he’s doing exactly what he’s meant for.
“When I was very young I wanted to be a football player and a pilot, and at some point I decided I wanted to be a doctor and I stayed fixated on that course and never strayed. In school, I was pre-med from day one,” said Brandon, who in March started a personal physician practice in Rancho Santa Fe, an effort to bring more inter-personal care to patients amid a rapidly changing healthcare climate.
Brandon grew up in a medical family. He’s been a doctor for 20 years, and some of his first impressions of the field came from watching his favorite show, “Marcus Welby, M.D.,” a 1970s TV medical drama about a much-loved family doctor with a kind bedside manner. His dad also had a family practice in San Diego for decades, where Brandon ended up working alongside him for many years.
“The show reminded me so much of the atmosphere I was growing up in,” said Brandon, a father of four boys and a sports aficionado. “My dad was everyone’s doctor and patients were like family. That’s what being a doctor is all about.”
Brandon’s new practice is a reflection of his desire to return to the traditional values of offering warm, individualized care — of being both a doctor and a member of the family. Instead of taking care of several thousand patients, as many doctors do, Brandon’s practice is limited to only 100 to 150 patients and he offers constant oversight.
“I get to know my patients,” he said. “Instead of just looking at a patients’ charts when they come in with a problem, I’m looking at their charts regularly and contacting them every month or two. I’m always looking for new ways to better treat them, and if something comes up I contact them.”
Over the past few decades, doctors have increasingly become conduits of regulation, Brandon said, meaning that insurance companies essentially decide what doctors can and can’t do. With recent governmental changes to the healthcare system, Brandon added, that interference has accelerated.
“We’re handcuffed,” he said. “You can have the best doctor in the world and still that doctor is controlled by a third party.”
That’s why Brandon said there is a growing need for the healthcare model he offers — one that operates free of insurance and Medicare. That doesn’t mean patients can’t have insurance for major emergencies, hospitalization and expensive tests — and Brandon’s got a team of insurance consultants that can help patients get on the right plan for them — but when it comes to their primary and preventative care, there’s no regulation.
“I am not regulated by anyone but the patient,” Brandon said.
In a regimented system, there are certain protocols that must be taken, regardless of the doctor’s orders. For example, an insurance company may only allow treatment with specified medications, and even if a certain medication is not the doctor’s choice, he or she must administer it first as a trial and show proof of adverse effects before using an alternative medication. A doctor, may apply for an exception, however, the paperwork process can delay treatment and the insurance company still may not grant the exception, he said.
“In this practice, I can just give the patient whatever medication I think is best,” he said.
Another motive for bypassing the insurance system is patient privacy. Brandon said the electronic medical records system has become a regulatory tool used by insurance companies, which can gain access to records at any time.
“I think that’s an intrusion into the patient’s privacy,” said Brandon, who keeps his electronic records with him at all times on a portable drive. “The insurance companies aren’t looking at records to help patients; They are saying, ‘Let’s see where we can bump their premium up or ration something.’”
Brandon refers his patients, when needed, to specialists he has known for decades working as a doctor in San Diego — specialists he said he uses himself.
“I recently referred one of my patients who is having a baby to the obstetrician who delivered my four sons,” Brandon said.
In the case of hospitalization, Brandon follows the patient all the way through the process as a supervising physician at the hospital, working on a team with the hospital physician and being involved in all the discussions on protocol.
“In most practices the physician doesn’t go through hospitalization with the patient and that actually gives relief to primary care doctors that have many, many patients,” said Brandon. “The problem with that, though, is that the continuity of care gets broken.”
For more information, email firstname.lastname@example.org or call (858) 756-4749.
Brandon’s practice is located at the Fairbanks Village Plaza, 16236 San Dieguito Road, Suite 22, Bldg. 5, second floor, 92067.