Still, after 13 years of dealing with the day-to-day roadblocks that come with being a PCP and one of seven doctors sharing the same office, Cirigliano was increasingly frustrated. If there was a tipping point for him, it was the day four years ago when he was told the practice’s dictation service, something Cirigliano used religiously to send patients personalized, detailed follow-ups after appointments, was being eliminated in favor of automated, less expensive form letters. Now he was losing control of the one thing he had left: how he interacted with his patients. Cirigliano was so bothered by this that one day, one of his patients, Steven Dandrea, of Vineland’s Dandrea Produce, noticed it while getting an exam. “What’s goin’ on, Doc?” Dandrea asked. “Everything okay?”
“I’m getting chest pains,” Cirigliano joked, before telling Dandrea about the dictation service — and parroting his boss’s crackerjack suggestion for fixing the problem: ask his patients for the money.
Dandrea shook his head, upset that a doctor so dedicated had this kind of stress. “How much do ya need?” he asked.
Surprised, Cirigliano realized Dandrea was serious. “Whatever you can give,” he said, sure whatever it was would be a small drop in a very large, leaky bucket.
But a few weeks later, a check for $25,000 showed up in the mail. Cirigliano was shocked — it would pay for his dictation and then some. And then, a tiny glimmer of hope shot through him. Why stop with just the dictation service? What if he could find a way to get the support staff and space he needed to practice medicine the right way, where the patient comes first? Even though the idea of a partially patient-funded practice was new to Penn, Cirigliano’s enthusiasm was contagious, and in August 2007, the Cirigliano Clinical Care Excellence Fund was set up for the practice. Any costs that Cirigliano couldn’t pay from regular patient income would be covered by patient donations.
Whenever his wealthier patients came to see him, Cirigliano began laying out his vision of the perfect practice. All it would take was for them to write a check to help fund it. Among the first he asked was Zekavat. “It was an easy sale,” Zekavat admits. “Not only was I making a small investment in Dr. Mike that certainly benefited me, but it would also allow him to create a game-changer in medicine.”
“The guy is pure dedication, he’s pure doctor,” says Ed Snider, another of Cirigliano’s major patient backers. “So when he came up with this idea, I was really excited. I felt that he needed to have a better support staff and a better setup, so I offered to help him in any way I could.” Eventually, Snider donated $500,000 to the cause.