Dr. Dennis Fong was a solo practitioner in Walnut Creek, CA, where like many independent family physicians, he took care of his community for decades. He answered calls in the middle of the night, kept his clinic open 6 days a week, oftentimes left family gatherings to take care of one of the estimated 20,000 patients he treated over his 40 year career. His dedication to his patients is a testament to the human connection that lies at the heart of primary care. 

When practices began shifting from paper records to electronic systems, he refused to settle for an electronic charting system that in any way disrupted his ability to provide excellent care for his patients. His children Kyna and Conan Fong, who had grown up inside their father’s family practice, did everything from answering patient phone calls to negotiating with insurance companies. They too were shocked with how existing EHRs were primarily built to support coding and billing, hindering the intimate doctor-patient relationship and creating inefficiencies. They founded Elation Health to build a tool purpose-built for primary care clinicians and the unique role they play in providing patient-centered care. 

Dr. Fong found immediate relief in having a clinical-first EHR and was an Elation user for 14 years before he retired earlier this year. He recently sat down with the Elation team for a fireside chat with Elation’s head of primary care advancement, Dr Sara Pastoor, to reflect on what made his practice successful, even in the midst of unending changes in the healthcare industry, and what direction he sees healthcare heading in the future. 

The Keys to Dr. Fong’s Success 

Dr. Fong attributes his long term success as a primary care physician to a clinical model designed for all-around continuous, personalized, and coordinated care. By setting a high bar for himself as a clinician, Dr. Fong inspired Kyna and Conan to develop technology that is purpose-built for high-value primary care, empowering primary care clinicians across the country to use an intuitive tool unlike any other in the industry. 

Like most physicians in independent practice, Dr Fong experienced challenges related to getting timely and appropriate payment for the care he was providing. If he wanted to be able to continue caring for his community,  “Billing was the most important thing to the sustainability of my practice.” He worked closely with his staff, including at times, his own daughter Kyna, to ensure coding and billing processes were as streamlined as possible. Kyna recently leveraged her own frontline experience with coding and billing with the release of the industry’s first unified EHR and billing solution built to support high-value primary care. 

Dr. Fong’s Predictions on the Future of Patient Care

During the fireside chat, Dr. Fong also shared his insights on trends in primary care. He commented on two profiles in terms of patients. He believes that one cohort of the modern patient is looking for a patient experience that centers convenience. In that sense, he believes that primary care organizations, like some of the innovative organizations that are powered by Elation, will continue to grow. 

At the same time, Dr. Fong believes there is another cohort of patients that are seeking personalized, continuous care. He cautioned against large primary care models that focus on economies of scale at the expense of the doctor-patient relationship. “They want their family doctor to show up when they are in the hospital.” Dr. Fong laments that third party payers are unwilling to reimburse primary care clinicians for these kinds of vital interactions and he feels that it's because third party payers are inherently incapable of evaluating the value of individual cognitive services, which only the patient can evaluate. 

According to Dr. Fong, one way clinicians can overcome this obstacle in their ability to provide patient-centered care is through concierge medicine. “Concierge medicine is where we can make up for the third party payers who are unable to value cognitive care.” In concierge medicine, the practice requires each patient to pay a membership fee to be the doctor's patient and to cover services not reimbursable under insurance, in addition to billing insurance for covered services. In turn, patients are able to receive more patient-focused services and practices can maintain financial sustainability while ensuring high-quality care.