With a nationwide network of healthcare facilities, Lillian Care aims to deliver primary healthcare to underserved areas. Ärztenachrichtendienst spoke with founder Linus Drop about the concept.
So Mr. Drop, can you tell me briefly what it is exactly that you are planning with Lillian Care?
The concept is based on two components: We are opening general healthcare practices in medically underserved regions. To the patient, they look like normal medical practices. Inside, however, they are organized differently. First of all, our physicians are not in the practice five days a week, but instead are offering telemedical services from home on a specific days.
In many cases, physicians are no longer willing to relocate to these underserved regions. We want to make it possible to practice general medicine in rural areas without having to move the center of your family’s life there.
The second thing is the distribution of work. We have too few doctors in general, so we need a different distribution of work within such a practice. This is where we rely on a medical team, in which significant parts of the treatment are provided by non-physician staff. In our case, this will mainly be physician assistants, but community health nurses may also become involved in the future. This is what has long been practiced in many other countries – Scandinavia, the UK, and the US. The complex cases are handled by the physician, the simpler ones by the nurses – and the outcomes are equivalent or better than they are here.
However, we ensure that the physicians retain overall responsibility by means of supervision. We deliberately wanted to move away from concepts such as substitution and delegation, because such terminology reflexively triggers certain opinions. And what we are doing is something in between. A physician is involved in any treatment we provide. The goal is to find a balance: As much as possible should be handled by others, but the physician remains involved — simply for a much shorter period of time. Nevertheless, he or she can intervene at any time.
You are organizing the entire operation as a medical care center. How large will the individual facilities be?
Yes, it’s a medical care center, we can’t organize it any other way. But the physicians can also become shareholders. We don’t want the physicians to be „just“ employees, but also partners in the big picture. That’s an option, the physicians don’t have to do it, but we offer it to all of them.
Nor is it a matter of the physicians having to bring a lot of capital to the table. For the launch, we’re classically investor-funded. To get things rolling, we’ve organized the capital. For us, it’s more about getting the physicians more involved in the decision-making process and about commitment.
Size-wise, the practice is oriented toward two physicians in terms of patient volume. But the breakdown will be different: one physician or one doctor and 1.2 full-time positions for physician assistants or something similar. The units will be rather small, because the localities we want to go to are usually quite small.
All administrative things will be completely centralized, we want to keep that out of