Coordinating chronic care

alan glaseroff and ann lindsay

Stanford Coordinated Care represents a new health care paradigm for individuals living with complex chronic conditions. BeWell spoke with the program’s director, Alan Glaseroff, MD, to learn more about this new approach to caring for an underserved and often misunderstood population. Dr. Glaseroff, together with his practice partner and wife of 38 years, Dr. Ann Lindsay (Associate Director of Stanford Coordinated Care, as well as a member of the Stanford clinical faculty), moved to Stanford in November 2011 following a 28-year career in family practice and managed care in Humboldt County.

Would you share your story?

On Thanksgiving Day in 1983, I learned I was a Type 1 Diabetic. A normal blood sugar score is under 100 and mine was 1,000. At the time, my wife was pregnant and we had a two-year-old child. I cried for several hours when I learned the news because everything I had learned in medical school told me I would have a shortened life and I didn’t think I would be alive to see my children grow up. When word spread that there was a diabetic doctor in town, diabetic patients started showing up at my practice. I learned from them that I could thrive. We learned from each other and formed a peer group. I live a healthier life in many ways because of my diagnosis and I’m happy to say I am a grandparent.

What is Stanford Coordinated Care?

Stanford Coordinated Care is a benefit available to active Stanford University, Stanford Hospital & Clinics, and Lucile Packard Children’s Hospital employees and their adult dependents covered by Blue Shield and UMR insurance plans who have chronic conditions and are not faring well. 

Why do patients often come up short in self-management of chronic conditions?

Often, chronically ill individuals have a sense of fatalism, hopelessness or just feeling stuck that comes with a diagnosis. They don’t have a role model of someone with the same condition who is thriving. Often they are out looking for cures that don’t exist.

How can your team help?

We partner with patients. We are about activating and empowering people, not about getting them to obey their doctor’s orders. We are using the work of Kate Lorig, RN, DrPH, Professor Emeritus, Stanford School of Medicine — known for her work on chronic disease and patient education — to help people take control of their own lives through a structured peer-to-peer curriculum.

Who can participate?

Any employee or adult dependent with multiple chronic conditions enrolled in the Blue Shield plans may participate. If you are diabetic, have hypertension, depression, ongoing pain management, or are taking five or more prescribed medications, we’d like to hear from you. Anyone who thinks they fit the description can call us at (650) 724-1800 and we will do a short interview to make sure the program is appropriate. A quick self-assessment tool is available on the SCC website.

What does participation look like?

There are two ways to interact. The first is to enroll in Primary Care Plus, in which Dr. Ann Lindsay or I serve as your primary care physician; plus, you receive support for your physical, psychological and emotional needs. The second way to interact is to enroll in Chronic Care Support, in which you stay with your current primary care doctor, yet take advantage of the same support care services mentioned above.

Why should Stanford faculty and staff trust you?

First, we will not share any patient’s identifiable information with their employer. All Stanford sees is the aggregate data. Second, patients have control over whether they participate. If they fit our profile, they can contact Stanford Coordinated Care directly or their insurance company may contact them on behalf of Stanford Coordinated Care as an introduction to the program.   

Does it cost anything?

Those on a Stanford University EPO and PPO plan will not have any out-of-pocket costs to see their provider and care team. If you are a member of the High Deductible PPO Plan, there will be a contribution to your Health Savings Account for the initial months of participation. 

Any last thoughts …

We are putting the patient in charge — which is not how health care usually goes. I guarantee that this is a style of care most people have never seen before.

Interview conducted by Julie Croteau and edited by Dorothy Ryan