To "Patch" Adams, the Gesundheit Hospital may be a laughing matter, but it's nothing to sneeze at.
Adams is hoping to raise $5 million to build a facility in West Virginia where his unorthodox approach to medicine will be practiced.
In Adams' dream hospital, there will be no charges for medical care, no malpractice insurance and no deals over third-party reimbursements.
But there will be plenty of humor and clowning around.
The architect of this near-Utopian idea is Hunter Adams, a 50-year-old German-American physician who sometimes dresses as a clown for public appearances and goes by the nickname "Patch." For more than two decades, he has been treating small numbers of patients at his Gesundheit Institute in Arlington, Va. The title comes not from a response to sneezing but from the German word for wellness.
Now, he hopes to practice his brand of medical care on a larger scale in a hospital to be constructed with donated money in a town with the now-Disney-esque name of Pocahontas, W.Va.
Adams' philosophy of medicine is built on a handful of tenets, the key one being that the relationship between physician and patient should be based on trust, not fear, money or greed.
According to Adams, debt should not be associated with healing. When the focus is wealth and material possessions, too many patients are left untreated, he says. Instead, life should focus on nonmaterial riches such as faith, fun, nature, friendship and interactive healing. And healing includes large doses of humor, which Adams sees as curative. Once the patient leaves the hospital Adams wants to build, he will have gained a personal friendship for life instead of unpaid bills and massive paperwork.
Third-party reimbursement has made many businesses rich but has caused healthcare costs to rise, Adams said. "Reimbursement jargon" abounds at hospital association meetings, but there is little talk of patient care, he added.
"Often, these people sound more like Wall Street traders than professionals dedicated to alleviating human suffering," he said.
Malpractice is another common cause of friction between patients and their physicians. While doctors are human and make mistakes, "fear is not the baseline from which to practice medicine," Adams said. There should be a mutual trust between the patient and provider, and malpractice laws have only worsened the conflict and added to the rising cost of healthcare.
The Gesundheit Institute has been in existence for more than 20 years. Adams began to pursue his dream after first writing about it at the Medical College of Virginia. During his residency at Georgetown University Hospital in Washington, he quit and set up practice in Arlington in a three-bedroom home he shared with a few friends.
It was there where he began practicing what he had preached about in a college paper only a short time before. The response to his first efforts at practicing his style of medicine, he said, was so overwhelming he decided to build a hospital where he could treat more than a handful of people.
"I am not strong enough to practice traditional healthcare delivery. Their bottom line is money; mine is care," Adams said.
Adams, who believes that laughter can heal, practices what he preaches. At 6-foot-4 with a long ponytail, handlebar mustache and clown attire at the ready, he travels the world pitching his vision of the hospital he wants to build on a 310-acre site in Pocahontas. He foresees a 40-bed, home-style hospital.
He has stopped seeing patients so he can focus on his project, which he will update in a keynote address at the Symposium on Healthcare Design Nov. 16 in San Diego.
Adams describes the site as a "natural paradise surrounded by a 4-acre lake, mountains, waterfalls and ornamental gardens." The site was purchased in 1980 from a lumber company for $67,000. He, his mother and six friends provided the downpayment.
In Adams' hospital vision, there will be no formal fee charged regardless of the medical procedure. However, patients, depending on physical strength, will be expected to help the staff with hospital chores. This cooperative effort will help keep costs down. In addition to the economical reasons for pitching in, Adams said such teamwork fits in with his wellness model. "Wellness is the sum of everything that makes us healthier. In this model, patients become responsible for their own health," Adams said.
He contends that his hospital will hold down prices by eliminating the major causes of high costs: labor and space. According to Adams, hospitals charge about $15,000 for a Caesarean section. At Gesundheit, the procedure would cost less than $100, the price for a scalpel, gloves and epidural. There would be no charge for a room, surgeon or anesthesiologist.
All costs will be covered by donations that Adams hopes will roll in.
His goal is to provide high-quality care at a minimal cost, perhaps less than 10% of the national average.
If everything goes according to budget it will take about $5 million to open the West Virginia hospital, and another $1 million annually to operate the facility, Adams said. That includes staff salary, medicine, food and building upkeep.
"It is hard for people to give money for a dream. They have to be generous for their future. It has taken 20 years to raise $900,000," he said.
Adams' colorful personality and philosophy have gained him global publicity. For example, he has traveled to Russia to spread his humor and good wishes to hospitalized children. He has been profiled in several magazines and newspapers, including USA Today.
Adams said Universal Studios has acquired the film rights for his book, Gesundheit, his account of his life and work published in 1993. A spokeswoman for the studio said she had no details about such a deal or what kind of motion picture might be produced.
Adams came to his philosophy the hard way after growing up in Germany and Northern Virginia. His father died of a heart attack when he was 16, and he was placed in the care on his uncle, who committed suicide. Adams later tried taking his own life before checking into a mental hospital in Virginia.
The hospitalization was a turning point in his life because he saw that other patients were in much more dire straits than he, Adams said.
"My problems seemed trivial," he said.
Through this experience, he became convinced that humans thrive on love, family, friends, nature and happiness-key elements of the Gesundheit way. He said he hopes healthcare administrators pick up on his style of management.
"Bring about change by setting an example for diminished hierarchy and bureaucracy in the healthcare system," is his message to administrators. "Initiate open forums for staff and community. Work with legislatures and medical societies on long-term planning of a service-oriented model for healthcare delivery. Devote time and energy to making your hospital a more hospitable place."