Charles Dickens/M. Knolle: A Christmas Carol 2022

I DO love the word dystopia. It is a combination of the two words dysfunction and utopia. Many people had not heard of this word until recently when it became popular as we started living it. Utopia is a society that operates with complete perfection. Dystopian themes are literary or cinematic genres in which seemingly perfect societies are run under strict centralized control. The dysfunctional aspects of dystopian themes are inevitable as persons who are above the bell curve disrupt the mindless adherence to the government's programs which invariably (d)evolve into sinister plans to eliminate the undesirables above and below the bell curve. In this 21st century, there are truly those people whose god is centralized government. The only service to remain in good standing with their god is to vote for the government people who say they will give to the poor, hungry, homeless, universities, Pfizer, the United Nations, and then they don't have to do anything else to help anyone. Good deal.

Welcome to the 21st Century Dickens’ tale.

Most of us are familiar with Charles Dickens' A Christmas Carol in which Ebenezer Scrooge is cruel to his employee Bob Kratchit and by extension Tiny Tim Kratchit at Christmas time. This is something I have just experienced personally and it connects with the dystopian world in which we are currently living circa 2022. And just like Tiny Tim said at the conclusion of the story, "God bless us, everyone!", because I see God's hand in all of it and I am full of hope and joy.

You see, I have had a spotless medical career for my 17 years of practicing medicine. In fact, being a fairly congenial person with a strong work ethic, I have developed a rather positive professional reputation. But in the last 10 months, I have lost two jobs at major healthcare institutions in Pennsylvania doing what I love doing, which is practicing Hospital Medicine. I have not undergone any major personality or professional changes and continue to shower daily. If I would tell you the reasons for these contract terminations, it actually is quite humorous the straws at which they grasp to eliminate someone who doesn't mindlessly follow the establishment narrative. Whether I am right or wrong in my objections is irrelevant. For many years science has become increasingly politically contaminated in wide-ranging areas of study with open debate and free expression of ideas being replaced by censorship with dire consequences for the diversity of thought. Pandemic 2019 is just the latest and greatest.

Bah, humbug!!

On November 17th, 2022, I was told that my per diem contract as a hospital physician would be terminated; not for any particular incident that occurred, but just for not being an appropriate culture match or employment fit. This was not true, there were actually three incidents that I was dragged into as an involuntary participant. In all three issues, those who created the drama were 100% wrong and I countered their arguments with highly factual rebuttals proving their incompetence at the very least. These complaints against me were done by email/secure chats to which these individuals had attached highly positioned physician administrators. Nobody spoke to me face to face because that would require the strength of truth to be on their side. My factual arguments were too solid and they knew they had no grounds on which to fault me.

Suddenly one of the most amiable and easy-going physicians in the hospital is an “employment fit” problem and was fired without warning. And if you think that firing someone right before Thanksgiving with the upcoming Holidays is bad, you ain't heard anything yet.

Move over Scrooge!!

My contract stipulated that I am required to give them 90 days notice before terminating my contract. That way, they have time to find another physician to fill my vacancy. Out of decency and a strong work ethic I would never dream of violating that. Likewise, the contract states that they are required to give me 90 days notice before they terminate my contract. So, on November 17, 2022, I was handed a letter that terminated my contract taking effect in 90 days (February 15, 2023) BUT they would not offer me any work shifts during that time and they took away the shifts I had already signed up for. Being a per diem physician, I sign up for available shifts and was often working more than full-time hours, for which they were very, very grateful due to physician shortages and my flexibility of working day shifts and night shifts at three hospitals. I had many shifts already scheduled.

They knew the very second they handed me the letter that I needed a new job. If I applied for any physician job on that very same day, due to credentialing, I would not be able to make a single penny for at least 90 to 120 days. In addition, with the contract still active, I cannot apply for unemployment. So, the termination letter I received, for not doing anything wrong, told me to mow lawns, rake leaves, or shovel sidewalks to feed my family for three to four months. Jesus said, “Forgive them for they know not what they do."

The healthcare system is extremely dystopian at this time. They truly believe they can act with impunity no matter how much they hurt others because they are just following orders from the higher-ups. Kinda like some guards in the past. To some degree, they had unlimited funds and they eliminated almost all competition. But as everybody can tell you, their system is broken and imploding and their unlimited funds are drying up as people are abandoning them in record numbers. I almost hate to pile on them when they're down, but one of these mega-hospitals just announced their annual Christmas gift to their hard-working employees only to take it away a couple of days later saying that times are tough for them. We need to defund these broken healthcare systems by drawing people to a better way. Drum roll, please.

Integrity Health Alliance DPC

We are proud to announce the opening of Integrity Health Alliance LLC (IHA) which has been long in the planning and divinely inspired. IHA is a Christ-centered direct primary care (DPC) practice that operates like a gym membership where one pays a low monthly membership fee in a tiered fashion depending on one's needs as well as family plans, student plans, home visit plans, and extra optional add-ons. As a result, one does not pay for office visits, blood draws, simple procedures, sick visits, or your yearly physical with blood work. We even include a yearly functional nutrition assessment with diet plans. Much can also be done virtually, and with Fitbits or Apple Watches, vital signs can be obtained instantly. Home visits have an extra fee, but are an available service. IHA has already contracted with a pharmaceutical wholesaler and laboratory services for drastically reduced prices. The medications will be delivered to our dispensary the following day for chronic meds. Our goal is to keep you out of hospitals, urgent care centers, emergency departments and even pharmacies. We will be able to provide IV medications as well as IV hydration and IV vitamin replacement. There will be a sauna, gym equipment with trainers, exceptional physical therapists, hyperbaric oxygen therapy, terahertz therapy, and much more.

IHA will not bill commercial insurance or Medicare/Medicaid (MC/MA), but patients may submit any covered charges to these entities for reimbursement. The health insurance industry has transmogrified into a heartless monster who “negotiate” with hospitals, pharmaceutical companies, durable medical equipment companies, etc. and as a result market forces have been removed and prices are artificially and arbitrarily set outside the ability of people to pay out of pocket. As a result, patients are held hostage to these behemoth companies. How else can one explain a Tylenol given in the hospital being $40? At times your copay is higher than the wholesale price so if one pays cash, the price is phenomenally lower.

With the DPC model, one is encouraged to obtain a medical share plan or health saving account with low premiums to only cover catastrophic events or expensive chronic medical issues such as chemotherapy. The DPC medical model is particularly attractive to people who put effort into living a healthful lifestyle and are tired of paying high insurance premiums with large deductibles and copays and never derive any benefit. So, in addition to the drastically lower cash pay options and not being constantly directed to the ER or urgent care centers when it's not convenient for the traditional “fee-for-service insurance practices”, healthcare costs are significantly lower and the quality of service significantly higher. People can even keep their commercial insurance if it is part of the employment package or MC/MA and submit any charge that is covered. This is a concept that is becoming increasingly popular and eliminates all the middlemen between you and your physician.

By eliminating the middlemen, who add no value and add a tremendous amount of waste, the DPC physician must only see approximately ¼ to ⅓ lower number of patients than what a typical fee-for-service insurance primary care physician must care for to remain profitable. As a result, you often have instant access to your physician 24/7 by phone call, text, email, or same-day/next-day appointments. Now, this next sentence is extremely important. Being a private membership association, the practice is not beholden to all the useless hard-stop electronic medical record barriers required to document and bill insurance, which is time that can be better spent with the patient.

It is also very important to note that Integrity Health Alliance is a lifestyle medical practice. We will focus on health maintenance rather than simply enabling disease progression by escalating western medications. We will address the integral unity of the mind, body, and spirit on overall health. Where those three spheres overlap in our corporal body are areas of potential injury which is manifested by inflammation. Even western medicine is finally acknowledging that chronic inflammation is the underlying pathophysiology of most chronic diseases.

While what I am saying here sounds very mystical, in reality, it is only semi-mystical. Most of it is very complex biochemistry following the three laws of science. And since IHA understands that science is the discipline of discovering the blueprints of God’s creation, we believe these laws are immutable other than when God chooses to intervene to the contrary.

Since repetition is the key to mastery, we will continually coach members on ways to reduce chronic inflammation including diet, management of obesity, exercise, stress management, restorative sleep, sunlight exposure, and simply the benefits of being out in nature. We will work as a team of which the member is the captain and we are there to support, encourage and provide information and accountability. Our founding team includes a doctor, a registered nurse, and a functional nutritional therapist. We will be contracting with various physician subspecialists, physical therapists, a Doctor of Naturopathic Medicine, fitness instructors, massage therapists, behavioral and Christian counselors, etc. for you as needed. We will be investigating various alternative medicine modalities such as hyperbaric oxygen and ozone therapy.

I will not lie to you, although much already is in place, this is a work in progress. But we will grow together and as the Bible says iron sharpens iron. There's much that we will learn from each other.

Finally and most importantly, we will be a community of like-minded individuals that will stand and support one another in these days of darkness with even darker clouds forming on the horizon. We need to have the courage to stand against the climate of fear and being prepared is the best way to control fear. As such we hope to teach classes on nutrition, gardening, canning, survival skills, hunting and be a co-op community that will be spreading as new locations are started. God has brought very talented people together who are eager to lend their talents and the fruits of their labor.

Our first location to open will be a spacious area on the second floor of Trop Gun Shop in Elizabethtown that is generously being leased to us by the owners. This space was designed by a New York interior decorator and is absolutely gorgeous. Aesthetics is a priority for us and we want these medical facilities to not be like the Department of Motor Vehicles where you are a second-class citizen. We want all our locations to be such that you feel as though you are an exclusive member of a private club. There is a bar where juices and smoothies can be prepared and a kitchen for teaching healthy cooking classes. And if you're wondering, during the daytime hours on weekdays the downstairs shooting range is less often used and for the most part, you will only hear soothing Christian music playing overhead. For many of us, the sound of the Second Amendment ringing out in the distance is a sound of comfort. I can guarantee you that we will be safe!!

If so much of the groundwork had not already been put in place over the last 10 years or more by the pioneers of this new direct primary care model to the point where it is tried and true as well as plug and play there is no way we could do this. Also if I didn’t have the other two founding team members Sarah Thompson (RN) and Tanya Jarrett (Masters of Public Health and Functional Nutrition) with me doing amazing organizational work as I am preparing the clinical aspect, I might also be dead in the water. It takes faith and courage to do something new both as the physician/providers and as a new member/patient. But there are times when we have no choice and need to resist the paralysis of analysis. These are the times when God pushes us out of the boat and onto the water to walk in faith in He who can calm the storms. And if you have read all the way to this point, you are one of us, that when Nebuchadnezzar commanded to bow, three didn't.

On December 25th, 2022, the birthday celebration of our Lord and Savior Jesus Christ, Integrity Health Alliance will be born. We will be starting at ground zero from a financial standpoint and have already put in thousands of dollars personally, that we don't have, in the process of sowing seeds of this vital ministry. But we know that we are building a metaphorical ark to escape the economic and medical tsunami that is about to strike our shores.

Please consider being a founding member of Integrity Health Alliance and as God leads, possibly giving further support via Give Send Go to what I believe is a ministry of protection and healing.

In Jesus Christ’s name.

Dr. Mike Knolle, DO