This practice is designed to deliver a different level of patient care, one that links excellence in physician and physician extender care with patient engagement. Ours is a small practice, with two physicians, Dr. Hansen and Dr. Holzer, both of whom are neurologists, and Lisa Walker, RN, NP, a nurse practitioner. Having a small treatment team allows uniformity in treatment philosophy and ensures that there is both consistency and continuity in each patient's plan of care. The small size of the practice also helps ensure that the highest level of patient support is provided, across the spectrum of appointment scheduling, prescription management, insurance company communications and patient access.
The initial visit is an intake evaluation with a physician, during which a treatment plan is developed. A follow up visit a few weeks later is scheduled to review the patient's progress and subsequent visits are arranged, initially as often as a few weeks to a month, and then commonly moving to visits each two months if the patient is stable on the treatment regimen. This is a practice where all the providers are involved in the care of each patient which means that follow up appoints are made on a rotating basis.
There are times when a patient needs to be seen before their scheduled follow up appointment. This might be in situations where there is a problem with medications or if there has been a change in the underlying pain issue. These "work-in" patients will be seen by the first available provider. For patients who are doing well enough, we can spread visits out to each three months, which is an interval of supervision in accordance with current CDC Guidelines.
We strongly believe that each patient's involvement with their own care is critical—a patient who is seen at this practice must be an active participant in their treatment, committing to activities such as directed self-education, medication compliance, and regular, sustained use of complementary approaches such as exercise, mental health engagement, and practice of health promoting life-style behaviors.
Managing complex neurological disorders, especially treating severe chronic pain with maintenance opioid therapy, is difficult and time consuming. Because of intense government agency scrutiny, regulatory requirements and mandated compliance practices, given typical reimbursement methods, it is not possible for a small practice to provide the needed quality of care.
For this reason, patients who are being treated with chronic opioid therapy, need to participate with the practice on a concierge basis. More information about the concierge policy can be found in the "Concierge Medicine" and the "Practice Policy" sections of the website.
The fee for this is commensurate with what is typically charged for primary care concierge service, $1500 yearly.
Another feature of the practice is the ability to perform remote face-to-face encounters through internet video and audio linkage. A telemedicine exam room has been equipped with HIPPA compliant high resolution audio/video, also employing a remote controllable pan/tilt camera. An office visit of this sort is conducted in the usual fashion, with a patient completing the pre-visit paper work, having vital signs taking and having a preliminary assessment done by nursing personnel. Applicable laws are such that a remote office visit is deemed to have taken place where the patient (not the provider) is located. This type of remote encounter may be necessary in some instances in conducting follow-up visits for established patients.
Robert B. Hansen, M.D.
Leigh Professional Building
6275 East Virginia Beach Boulevard
Norfolk, Virginia 23502