Stanford will soon be home to a brand new clinic aiming to revolutionize primary healthcare.  Starting April 1, 2012 a comprehensive team of medical professionals will open a clinic specializing in the care of chronic diseases. Dr. Alan Glaseroff, MD, has relocated to Stanford to serve as the clinic’s medical director.  His wife, Dr. Ann Lindsay, MD, will also work in the new clinic.

The clinic aims to target chronic diseases that are often poorly managed by traditional methods of healthcare.  These include illnesses like diabetes, heart failure, asthma, or hypertension.  Stanford hopes to improve disease management by closely monitoring patients and offering unprecedented access to physicians.

“Our work force will emphasize that our relationship with the patient is a continuous one,” said Glaseroff.  He added the clinic will use unusual methods to sustain relationships with patients and track progress.  These include home visits by physicians, round-the-clock nurse availability and advocates who accompany patients on visits to outside specialists.

“We’re advancing a much more coordinated model of care,” Glaseroff said.

Glaseroff and Lindsay are renowned for their work on the primary care system in rural Humboldt County.  Since 1983, they have been responsible for managing their own clinic and coordinating county physicians under a single system.  Glaseroff and Lindsay implemented a chronic care model developed in Seattle, aimed at improving the health of patients with serious, long-term illnesses.  In Humboldt County alone, the number of deaths from diabetes has decreased by 29 percent since 2003.

According to Glaseroff, the intervention aspect of his chronic-care model creates a win-win situation.  Patients with chronic illnesses often need the most expensive treatments.  By aggressively treating chronic disease, patient health is improved and healthcare costs go down.

“It’s been said that 30 percent of money spent on chronic illnesses doesn’t need to be spent if you do a good job,” Glaseroff said.  He hopes this model will empower the primary care system to meet patient needs while improving the state of healthcare in America.

“This is what the country desperately needs in terms of health reform.  We are providing a blueprint to inform the national health discussion,” he said.

Dr. Philip Pizzo, MD, Dean of Stanford School of Medicine hopes the clinic can help manage costs and improve coordination among service care providers.

“Individuals with chronic diseases have multiple medical conditions leading them to see multiple care providers,” wrote Pizzo in an email to the Daily. “That can lead to fragmentation, redundancy and adverse effects.”

Pizzo stated that a more comprehensive effort on the primary care side prevents unnecessary use of specialty or emergency care.

Glaseroff is not alone in his quest to reform primary care.  Stanford School of Medicine’s Clinical Excellence Research Center (CERC) has been heading research on how to improve healthcare and promote reductions in spending.  The center develops and tests healthcare system interventions.  One of its projects includes the assessment of tele-medicine, a method by which technology can allow doctors to reach patients from remote or distant locations.

Dr. Arnold Milstein, MD, MPH, is the director of the CERC and was responsible for recruiting Glaseroff to direct the new clinic.  Milstein’s work on the concept of an ambulatory, or non-hospital based, intensive care unit model will form the basis for the clinic.  This means that staff will be a team with different specialties, and will thus be able to treat multiple aspects of patient health.

Glaseroff hopes to take this model and tailor it to the needs of chronically ill patients by using the methods he has successfully implemented in Humboldt.  He emphasized the need to treat the whole patient, not just the disease. For instance, many patients with chronic diseases such as diabetes or high blood pressure also suffer from social isolation, depression, or hopelessness.  He said treating these issues of emotional wellness are just as, if not more, important than treating the disease.

“We’re reducing isolation and hopelessness so people feel empowered to take control of their lives,” Glaseroff said.

The clinic will initially serve employees of Stanford Hospital & Clinics in a temporary location on Welch Road.  Eventually the clinic will move to its permanent home in the newly remodeled Hoover Pavilion.

As the clinic becomes more established, Glaseroff hopes to see expansion throughout Silicon Valley by working with preexisting healthcare providers, such as Palo Alto Medical Foundation or Kaiser.  He stressed the need to cooperate with systems already in place.

“Patients needs are what drive our decisions, not what turf we stand on or what organization we work for,” said Glaseroff.  “We’re aiming for the perfect model that can work in the real world.”