"Our ten-year old daughter had not been herself for months (no pep, many cold-like symptoms, fairly frequent upset stomach). Having insurance with deductibles we had not reached, I did not want to pay a $100 for an office visit when I figured we'd be told our daughter was growing or that many viruses were going around. I was also busy and balked over the wasted time involved in visiting our clinic for something so vague.

My husband thought we should relieve our worries by calling Family Medicine--we knew Dr. Dappen and knew he had left the clinic to establish a new practice. Reluctantly, I called. The reluctance ended when Dr. Dappen answered the phone himself. I described my daughter's symptoms and a few questions had him ruling out the likelihood of a tick bite, parasite, or serious underlying illness. Within minutes, he got onto allergies (although this was winter, our daughter has summertime allergies) and her symptoms fit the possibility. He recommended we try her allergy medications as a logical (and harmless) first step. If this didn't work within a few days, he thought we should consider some lab work and an office visit to rule out more serious possibilities.

As it turns out, this was the needed step. The allergy medication has made a huge difference in how our daughter feels and it's great to have our spunky girl back. The consult, which cost $45 and took 15 minutes, made me a true believer. Our former clinic seems like an expensive dinosaur by comparison."
-Janet S.

"While I was traveling for work, an ugly infection erupted on my hand. I did not have time to find or visit a local doctor. Fortunately, as a patient, I take my doctor with me everywhere I go. I called the toll-free number and because Dr. Dappen was talking with another patient, I left a message and a return number. Five minutes later he returned the call. Given my situation, he told me how to sterilize, lance, and drain the infection. This was amazing in itself, but what was incredibly cool was how he used his computer to locate a pharmacy in my area while we talked. After telling me how to deal with the infection, Dr, Dappen gave me the address of the pharmacy and said a prescription for an antibiotic would be ready to be picked up within an hour. Finally, he ordered me to call back in two days with a progress report (he also reassured me there would be no charge for the progress report). What an amazing service this is for those of us who are on the road a lot."
-Jim D.

"My son was sick with a fever for 5 days… I tried scheduling an appointment with our pediatrician, but was told the physician was out of the office (a Thursday) and would be gone until Monday. I was referred to another physician who I did not know and who was not available that day.

Not wanting to wait thorough the weekend, I called Family Medicine (Dr. Dappen already knew my son). When I called, Dr. Dappen answered the phone and ten minutes of conversation led him to conclude that an office visit wasn't required yet, and to recommend an antibiotic. He called in the prescription, and within three hours of my call, my son had taken the initial dose of his medicine and was starting to feel better.

The medical decision-making to treat my son may have been routine for Dr. Dappen, but what was not routine was his accessibility--I spoke to him immediately, not to a receptionist or nurse. Also there was the convenience of not having to travel to the doctor's office, not waiting to be seen, not waiting at the pharmacy while the prescription was filled, and not paying an arm and a leg ($40 for the phone consultation). The medicine was covered by our insurance.

Compared to the time I wasted in trying (and failing) to get help through our old practice, it's easy to see the advantages of this new practice."
-Submitted by a patient who asked to remain anonymous.

"The word is getting out. You are written up in the California AFP newsletter, and Jack Lewin, Executive Director of the California Medical Association used you as an example in a talk today. This is great. I tell them you were a Californian family practitioner!"
-Joe Scherger., MD

"I, for one, want to give you -two thumbs up! Good Luck!"
-Ian T., MD

"When I retire, or when your system of healthcare is finally recognized by the healthcare industry (whichever occurs first), I plan on adopting a similar plan for the practice of pediatrics in my area."
-Samuel S., M.D., F.A.A.P.

"The article in AMN of 10/20 has just come to my attention. For more than thirty years I practiced medicine within a small independent practice associated with Harvard Med. What is clear to me is that the system must change. Harvard is rewriting the curriculum at this time. In this process the change that must come in medicine is at the bottom of priorities. I understand and appreciate what you are doing. We must learn how do deliver the best of care at a vastly reduced price. Keep up the good work. May your business plan be a success so your example can flourish."
-P.A., MD

"You should be commended for GOING FOR IT! I share your opinion that this may solve the current crisis in health care."
-Warren S., M.D.,
Diplomate - American Board of Family Practice
Medical Director - B. H. Family Medicine

"Congratulations on a great concept. I look forward to hearing more about your practice model in the future."
-Paul H., MD

"I just read the American Medical News article describing your practice, and I am impressed and amazed. Impressed because you are making a cutting-edge practice work. Amazed because as a second-year family-practice resident in FL, I recently wondered how practices could change to use more EMRs and phone services - I wondered exactly what you are doing!"
-Robert R., MD, Family Practice Residency

"I have dreamed about doing something like this, but did not know anyone else had thought of it."
-Stephen F., MD

"I read with great interest an article ... I just quickly looked at your web site. I commend you and your efforts and will review your web site in greater detail. Keep up the good work and innovation."
-John D., MD

"I would like to learn more about your email/phone practice, which I think is a great idea."
-Paul S., MD

"I am a busy, office-based family doc in southern Oregon, and spend time with patient business on the web, nothing formal, and saw the article about you... I have often wished I would be able to do this more, and get paid for the time and expertise put into this...."
-S.O., MD

"I am terribly interested in how you are pulling it off, how it works for you, and how the logistics work.... this is courageous and insightful!"
-R.R., MD

"I read the article in the AM News and found your approach interesting. I would like to develop a similar plan here in my office."
-Jerry R., MD

"First, thanks for being an innovator. I am very interested in your concept, read the AMA article, and just quit as an employee in an integrative medicine practice where we took insurance. ... As an innovator I tried to work within the system for years to help it evolve. This year I accepted that we must step outside of the system and create a new model such as you have. Keep up your innovation."
-W.A.,MD

"Thank you for giving me so much of you valuable time to talk about your practice. I was and still am fascinated by your business model. I keep thinking about it and agree with you - why aren't more physicians doing this? It just is so perfect a plan. Your passion and enthusiasm is contagious. I admire the work you are doing and I am certain you will be rewarded for it. Thank you again. It was such a pleasure!"
-S.K.

"It is obvious that your patients love what you are doing. As an undergraduate major in communications - I've always believed that communication either makes or breaks things. and I think communication is one of the biggest problems in our healthcare system today. You are doing so much to open the communication channels to your patients! I wish you great success!"
-Deborah B. Sr. Director of Sales

"I looked over the info you sent earlier, and it all looks awesome. Can't wait to get sick! I do really think this is great, and I'm excited to become a patient (again)."
-Cailan N.

"We are thrilled that you are advancing the use of technology."
-John and Mary

"This is fantastic! This is going to be a very big hit - congrats for being on the vanguard!"
-Pauli F.

"Congratulations on revamping healthcare. I'd like to sign up ASAP and continue my relationship with you as my primary doctor."
-Denise I.

"I am very impressed with what you have accomplished and I really want to continue getting medical/health advice from you."
-Brad T.

The Washington Post: Calling Dappen
Excerpt: ... "Dappen's philosophy appeals to Meg Hyland, an emergency room nurse who is one of his newer patients. "He has taken telephone triage to the next logical step," she said. "I think Dr. Dappen is a pioneer, a creative guy who's trying to make a difference and come up with a better system."
Source: Washington Post article "Calling Dappen" http://www.washingtonpost.com/wp-dyn/articles/A44864-2003Sep8.html

Benefits News: Medical Visits via Phone, E-mail Promise Cost Savings
http://www.benefitnews.com/detail.cfm?id=5023&terms=|xxxar||xxxnw||xxxeb||doctokr||xxxnw2|

American Medical News: Doctor Redefines Visits with Phone, E-mail
http://www.ama-assn.org/amednews/2003/10/20/bil21020.htm