[INSPRATIONAL MUSIC STING] - Hi, everyone.

Steve Adubato.

We kick off the program with Dr. Steven Brunnquell, who is the President of the Englewood Health Physician Network.

Doctor, good to see you.

- Nice to see you again, Steve.

- You told our producers something that we wanna share with everyone.

That there are keys to keeping out of the emergency room.

I go to the emergency room way more than I should, overreact to things.

What are some keys that we should be learning to avoid the emergency room, which only drives up healthcare costs?

- Well, particularly, this time of year, in the season that we're launching into right now, some of the ways to stay out of the emergency room is get a flu shot, get the latest COVID shot.

If you're over 75 or 80, you might consider an RSV vaccine as well.

And the second part is, you know, if you're not feeling well, get tested because we have medicines for influenza, we have medicines for COVID, and all of those things I just mentioned, the vaccines and those medications, they won't prevent illness, but they'll keep you out of the hospital.

I can't think of anybody who wants to be in a hospital.

- Doctor, let me ask you something.

I'm not gonna get into a whole political conversation about vaccines or what people believe or don't believe, but what do you say to folks, regardless of their, quote, "politics," "I am anti-vax.

I don't believe in vaccine."

Talk to them, from a medical, scientific, and clinical perspective.

Please, Doctor.

- I encounter these people all the time and I don't try to twist people's arms.

I say a couple of things.

I said there is plenty of scientific evidence that COVID vaccine in particular probably saves 3 million lives in this country.

It is true that influenza vaccine doesn't always prevent flu.

It is true that COVID vaccine doesn't prevent COVID, but it will keep you out of the hospital.

COVID is much less virulent than it was early on, clearly.

We're not seeing the death rates, and that's a good thing.

We'd like to keep it that way.

We also don't wanna transmit to your family members of loved ones.

And I say, I get a COVID shot and a flu shot every fall.

And if you don't wanna do that, that's your business.

But if you don't and you get sick, come and get tested because I can't tell the difference between flu and COVID these days.

They look identical and there are different treatments for each one.

- Doctor, talk to us about this.

This trend and the impact it potentially has on the delivery of healthcare.

Independent practices, dwindling, getting smaller as larger physician groups take over.

Large-scale mergers.

You got Walgreens through Village MD acquiring practices at Summit Health, all kinds of big mergers.

Bigger is better.

What do you believe all this means to the average citizen/patient who just wants to get healthcare, medical care?

Please.

- So it's getting harder and harder, I think, to be an independent practice.

The cost of overhead, the cost of insurance, the regulations, the billing.

Most of my colleagues really just wanna treat patients.

They really don't wanna run a business.

And so yes, we here at Englewood, we've grown to 700 providers, but we've also not wanted to become corporate medicine.

We want to provide the best care for people.

And so yes, we have a robust physician network with all the medical specialties you can think of.

And yes, we've organized them into some very large multi-specialty offices, which I think provided convenience for patients because we're all on the same insurances, we're all the same electronic medical record, it's all shared, but we've also kept the neighborhood field.

We've kept our local primary care offices.

- How?

How, Doctor?

- We keep them where they work, particularly in our urban neighborhoods where people don't have transportation, they walk to their doctor's offices.

We've kept those offices open and then we've located the multi-specialty office nearby so that when they need a specialist or they need a CAT scan, or they need a stress test, they can get it conveniently.

They don't have to come to campus to do those things.

- Let me ask you this.

There's clearly a shortage of physicians, particularly primary care physicians.

What do you see out there, Dr. Brunnquell, in terms of the physician market?

Who wants to go into it, who doesn't?

And how COVID and the experience of COVID for physicians has impact?

I know that's a loaded question.

- Yeah, I'll grant you, that's a loaded question, but you know, I love my job as much as I did when I started 32 years ago.

- COVID hasn't changed that.

- No, it hasn't changed that.

It was tough.

I'm not gonna kid you.

You know, the spring of 2020 was frightening.

It was terrifying because remember, this part of the world was the very beginning.

We were among the first to see these folks, but we chose this profession because we love taking care of people.

So if I can, like I said earlier, I can unload from doctors' busy days things like running the billing part and running a payroll and hiring staff.

If I can take that away from them and allow them just to see patients, and there's still lots of people who wanna care for folks.

I think that sometimes some of my colleagues have become sort of perhaps a little bitter and a little resentful of some of the things that they've been asked to do in the last 20 years and what medicine has become.

But what I do in the exam room, when I close the door and I ask you, "Mr. Adubato, how can I help you today?"

That has not changed.

Yes, I now document on a computer, which is the single biggest... (chuckles) - You gotta do electronic medical records in real time or no?

- I'm actually using an AI product at the moment to help me write my notes so I don't have to do that.

But we can do that another day.

But what I do in the exam room hasn't changed.

I listen to what the patient has to say, I do a physical exam and I share with them what our plan is.

That part has doesn't change.

Yes, we have to deal with insurance companies and we have to deal with the government and we have to deal with all sorts of other stuff, but I'm trying to take that away from the doc so they can focus just on caring for patients.

- Last question.

You mentioned government.

If state government were to take one action that would be helpful to help retain our much needed physicians, what would that be?

- We're having difficulty right now, Steve, getting our new doctors credentialed on insurance plans.

So when I hire a new doctor, and we take all insurances at Englewood, I want them on the insurance plans so that when people come to us, they can be insurance agnostic.

It doesn't matter the coverage you have, we'll take care of you.

We wanted to get rid of that barrier.

The insurance companies are dragging their feet and I would love to see the state do something to say, "Hey, listen, if there's an eligible, certified doctor who's capable, has the documents, and you have that documentation, here's the time limit.

You have to include them.

- Dr. Steven Brunnquell.

I wanna thank you so much, Doctor, for exploring a whole range of important issues that affect all of us, regardless of where we live or the issues we're dealing with medically, clinically.

Thank you, Doctor.

- It's been a pleasure.

Thank you, Steve.

- You got it.

Stay with us.

We'll be right back.

- [Narrator] State of Affairs with Steve Adubato is a production of the Caucus Educational Corporation.

Celebrating 30 years in public broadcasting.

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And by The Port Authority of New York and New Jersey.

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