After 23 years in town, Asheville Integrative Medicine will close next month, a victim of COVID-19 and the ensuing recession.
“People just stopped calling,” says Dr. James Biddle, the physician who runs the practice. “When you’re worried about paying the bills you have, you cut back on expenses.”
Unlike most medical practices, Asheville Integrative Medicine doesn’t accept insurance. Biddle, who’s board-certified in internal medicine, says he was among the first to take that approach back in 1999. Eliminating the paperwork required by insurance companies meant he could reduce the number of employee hours needed to fill out the forms and could therefore charge less.
Biddle doesn’t see that decision as causing the pending closure, however: Small businesses are particularly vulnerable during tough economic times. “That doesn’t make it any easier to hand out seven pink slips, though,” he notes.
Biddle has spent more than two decades offering his patients alternative treatments for common ailments that conventional medicine can’t cure.
“Most of what’s covered by insurance is inside the box,” he says. “When someone isn’t well, the first thing most doctors do is reach for a prescription pad. … We take a biochemical approach.”
Often, says Biddle, he can address what’s going on with vitamins or other treatments that have fewer side effects and are far less expensive than prescription medicines. He also counsels patients on ways to forestall illnesses by means of exercise, common-sense eating and sleeping habits, and other wellness practices.
Cleaning out the pipes
Ed Woeckener has been a patient since September 1998. He had high cholesterol and partially blocked coronary arteries, and after hearing Biddle speak at UNC Asheville, he made an appointment.
“He lives the way he tells other people to live,” says Woeckener, adding, “That’s important to me.”
Biddle proposed chelation therapy, which is usually used to remove lead and other heavy metals from the body. Although it’s not FDA-approved for cholesterol, Woeckener says he believes it’s helped him.
“It cleans out the pipes,” he explains. “I get it done every six weeks or so and I pay about $100. I’ll be 86 next month, so I guess it’s worked pretty well.”
Woeckener is one of about 500 patients cared for by Biddle and the practice’s seven employees. But as the pandemic spread and the recession deepened, they say, fewer people called for appointments.
Many professional practices are hurting
Biddle isn’t alone. In July, an email survey of more than 500,000 doctors conducted for The Physicians Foundation found that 8% of the roughly 3,500 respondents had closed their practices as a result of the pandemic, 43% had reduced staff and 72% had experienced a reduction in income. Of the latter group, 55% said their income was down 26% or more.
In North Carolina, the landscape for independent medical practices mirrors the national numbers, says Franklin Walker, vice president for rural health systems innovation at the N.C. Medical Society Foundation. He’s administering $25 million in government grant funds to help independent practices stay afloat during COVID-19.
The money, which came from the federal economic stimulus package approved in March, was allocated by the N.C. General Assembly. Independent medical practices can apply through Monday, Nov. 30, for reimbursement of expenses directly related to the pandemic, such as extra personal protective equipment, cleaning supplies, tents for outside testing and telehealth technology. The foundation also produced a webinar on how to determine eligibility and apply for funds.
“I wish it had been more of a general fund, but the money is there, and it might help a practice stay afloat,” notes Walker.
More than 560 practices have already applied for funds; any unused money must be returned by the end of December, he says. “I would encourage independent practices to apply. It just might be enough to help you keep your doors open.”
Biddle announced the closing in a letter that was posted on the website and also mailed to his patients.
“After 23 ½ years in this practice, it is with a heavy heart that I announce that AIM must close its doors by the end of 2020, due to financial hardships associated with the economic downturn,” the letter begins.
“Over the last two weeks, I have already felt some of the grief, shock, fear and concern that our clients have expressed upon learning of our closure personally. I understand that losing your physician and health-care support here at AIM may be deeply troubling for many of you. I share in your grief.
“I also share in the grief of our staff, who not only face an uncertain job market in troubled times but also the loss of their workplace family. Our staff here at AIM has been truly dedicated to improving your health; they express their gratitude for being able to contribute to that with a sense of integrity and loving teamwork. I feel proud to have provided a supportive workplace of camaraderie. I feel deeply saddened that we cannot continue.
“Lastly, I am grateful and honored that each of you trusted us to be your partners in your quest for better health. I am elated for each step of success that we have shared, and regretful for any missed opportunities or missteps. I’ve often stated, ‘The hardest part about being a doctor is being human.’”
“Sometime next spring, I do plan to open a new consulting-only ‘micro-practice’ under a different business name, with just me and a laptop computer. Alas, I will finally give up my old paper charts and convert to an [electronic medical record system], and most of our encounters will be by phone or video.”
Woeckener gives Biddle much of the credit for his continued good health.
“I’m still here, and my heart’s still going strong,” he says. “I’m hoping I can be one of the patients he continues seeing when he reopens.”