Ronald T. Garry, MD

"Dr. Garry was born and raised in New York. He was a scholar in Medicine at Stony Brook’s school of medicine and graduated with added distinction in research. He then moved to Boston where he did his Internal Medicine training at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School. While at BIDMC he received the Dr. James Tullis award for intellectual growth. Dr. Garry did his Geriatric Fellowship at Harvard Medical School and upon completion joined the faculty at BIDMC and Harvard Medical School. While in Boston, Dr. Garry was instrumental in setting up the first Acute Care for Elderly Unit (ACE) in Boston. ACE units are specialized geriatric units that improve outcomes for acutely ill seniors. Dr. Garry served as the medical director until relocating to Naples in 2002. Dr. Garry has lectured nationally on such diverse topics as elderly scuba divers, principles of geriatrics, acute care of the hospitalized elderly, and restraint reduction, among others. He has also published two books with Harvard Health Publications titled: Living Independently in Your Later Years and Living Better, Living Longer: The Secrets to Healthy Aging. He has written articles for CBSHealthWatch and Medscape and has been interviewed by various news outlets on health care policy and general geriatric topics. Dr. Garry serves as medical director for two assisted living facilities and a home care company. He is the subsection chief of geriatrics at Naples Community Hospital. He was appointed by Governor Jeb Bush as an expert to the Agency of Health Care Administration."

"Naples Premier Concierge started out as a reaction to the changing healthcare environment, both on a national as well as a local level. Medicare has created incentives for physicians to see more and more patients in a shorter interval. This has led to the generally accepted 10-minute appointments that most physicians use to see patients, which has led to frustration on both the part of the physician and the patient. Locally, Naples Community Hospital Healthcare System bought Anchor Health Centers. This was a reaction to the Affordable Care Act, which relies heavily on Accountable Care Organizations (ACOs). An Accountable Care Organization is a term with which you should become familiar. In straightforward language, an ACO is an organization that works with the Federal government to receive payments. The ACO then divides the payments to the individual members. Since the ACO can receive bonuses based on cost savings and quality indicators, there is a built-in incentive to keep costs down. Some of the principles that govern ACOs are similar to managed care programs. In order to form ACOs, hospitals have ventured into the practice of employing physicians. NCHMD, for example, has become one of the largest employers of physicians locally, leading to an unintentional loss of professionalism in medicine, as physicians are now employees just like any other hospital employee. This has led to a loss of control of one’s own office and general dissatisfaction among all parties. Physicians have reacted by not going to the hospital to see their patients and instead use hospitalists to admit their patients. Fractionated care is the result. A patient sees a physician or nurse practitioner (NP) in the office, a physician or NP in the Emergency Department, a hospitalist or hospitalist NP, and then eventually gets back to their primary care physician. Vital information is lost in all the hand-offs during this process, and has also led to patient dissatisfaction."