It all started with a pain in my groin, an ache I chalked up to maybe sleeping in an unfortunate position. By the end of the day, things “down there” had swollen and grown increasingly tender to the touch. When I awoke the second day, I was nearly in agony. I couldn’t call my regular (gay) doctor, who surely would’ve put me at ease right away. My options were limited, with no familiar medical expert available. After suffering far too long in silence, I delicately drove myself to the emergency room where a couple of “un-woke” medical providers, somewhat bothered by the necessity of asking a fairly-well-adjusted gay man some routine questions about sexual activity, diagnosed me with “epididimitis.”

That’s the name of a certain swelling of the testicles caused by a bacterial infection. In younger men it’s typically the result of sexual activity, but in middle-aged guys like me it often appears right out of the blue. The lab results confirmed things the next day, and after a rather large injection of antibiotics and a week’s worth of the same in pill form, everything returned to normal and I could sit comfortably once again.

So, why couldn’t I just call or go see my regular, gay primary care provider (PCP) when I first felt pain?

Because my PCP and others had recently left the Novant Medical group and I had no way to contact them! When I’d last seen him for a routine checkup, my PCP mentioned the office was considering a split from Novant some day. 

Little did we both know of the unexpected changes up ahead.

In the title of her Sept. 30, 2021 piece in The Charlotte Observer, Dr. Jessica Schorr Saxe, a local retired family physician, described the situation I was in just prior to the emergency room visit: When your doctor leaves a practice, you shouldn’t have to play hide and seek. She wrote, “As far as I know, healthcare systems have not sworn to put your interests first, nor been educated to respond to your innermost fears.”

Dr. Rhett Brown, Dr. Carson Rounds and Michael Sulewski PA-C, along with other associates, left the Novant Health owned family medical practice to open their own office. 

With the various laws guarding patient privacy and confidentiality as well as contractual agreements in place between healthcare providers and their corperate intities, it would’ve likely been illegal for them to reach out to me to tell me how to contact them after leaving Novant. And so, amateur sleuth that I am, I started Googling and making phone calls.

It had been about two months since I’d last seen the friendly face of Michael Sulewski PA-C, when I walked into his temporary office near Southpark Mall. I’d gotten on the email list after filling out the online form on the website I was directed to visit by the folks from Novant when I called the old office (“Hide & Seek” indeed). After he’d greeted me with a familiar smile, looked me over and refilled my prescriptions, I finally got to hear first-hand about my team of healthcare providers splitting off from Novant, about the current state of affairs, and about what the future would hold. Of course, my first question had to be, “Why?”

The short answer from Michael Sulewsky, Ph. D. was, “They changed the non-compete portion of our contract and we weren’t able to agree to the terms Novant offered. And so here we are.” I was seated in the practice’s temporary home, sharing quarters with Avance Care – Charlotte, Southpark. Several days later, I met (virtually via Zoom) with Sulewsky, Dr. Rhett Brown and Carson Rounds to learn more about the changes I’d experienced and the plans for their new practice, Avance Care – Midtown Charlotte.

Regarding the split with Novant, Dr. Brown said, “Novant has been a wonderful – fabulous – place to work and the folks there treated me well for ten years. The company made a business decision to include a more restrictive non-compete clause to my contract. I was unwilling to sign the new contract because it might force me at a later date to leave Charlotte to continue practicing medicine if I left Novant under the proposed agreement.”

Clearly, Novant still values his knowledge and expertise. They have continued to engage him as a consultant providing insight and direction relating to healthcare delivery and policies affecting the LGBTQ community. Dr. Brown is proud of the great success Novant has had from a human rights perspective. “Even though I don’t wear the same badge as before, I’m still committed to working together with Novant to do great things for the LGBT community.”

When I asked about the new name on their offices, the team was happy to explain things. Avance is a system of primary care practices across North Carolina with efficient and effective business processes grouped into an “operating platform.” The workflow and policies are continuously analyzed and tuned, equipping Avance providers with the means to deliver cost-effective healthcare services. They claim “industry leading” ratings for efficiency, quality of care and patient satisfaction.

Dr. Rounds and Dr. Brown, impressed with much of what they’d learned about and seen from Avance, took up the work of forming a new company to provide a legal structure to their healthcare practice. The fledgling business, Your Home, PLLc entered into an agreement with Avance, becoming part of its innovative healthcare delivery system. Drs. Brown and Rounds own the practice, while Avance provides the “platform:” innovative processes, software, procedures and healthcare delivery network. The relationship allows Rounds, Brown and their associates and staff to concentrate on delivering the best healthcare they can based on each patient’s needs. Meanwhile, the system takes away the burden of the myriad of non-medical tasks necessary to support a medical practice. Other physicians, providers and members of staff are employed by the practice and Avance. The goal of the new Avance Care practices, one enthusiastically embraced by all present in our discussion, was clearly stated as making Primary Care (a patient’s regular, familiar provider) the default choice for every healthcare need.

Dr. Rounds and Dr. Brown are both strong and vocal advocates for the healthcare needs of Queer folks in the Carolinas and have been instrumental in improving care for our community here in Charlotte and elsewhere. During our discussion, I was impressed by the insightful and hopeful things Dr. Rounds shared about some of the new opportunities the partnership with Avance affords LGBTQ patients. Trans patients in particular stand to benefit when services like hormone monitoring and management, vocal training and counseling are provided in a familiar and safe setting.

“The practice of medicine for trans and gay patients, etc. is not rocket science,” Rounds explained. “There are a few things to account for, but in terms of delivering the best care, the great leap is overcoming stigma and educating doctors on how best to serve this population.”

The company prides itself on its innovation but takes care to deliver those advances in healthcare with a distinctly human touch. When skimming through the medical information and resources available on the company’s corporate site, patient portal and mobile app, I was really impressed by the clarity and simplicity in those communications. The Avance platform felt remarkably comfortable and noninstitutional. I was really excited to learn about the services and features of my doctors’ newly established practice at Avance Care – Midtown Charlotte, and I’m equally excited to share some of what I learned with you now.

For instance, in addition to the regular physicians, PAs, medical assistants and staff I have already come to know and appreciate, there are several new team members with additional knowledge and skills.

The office is staffed seven days a week with open hours extending into the evening. Many “urgent” non-emergency medical issues (burns, cuts, allergic reactions, rashes, animal bites, etc.) can be treated on site and same-day appointments are available. In addition, many visits can now take place “virtually” when necessary or convenient, an example of Avance leveraging its technology strengths as well as valuable lessons learned lately in response to COVID-19.

On-site licensed and registered dietitians and nutritionists aid with diabetes care and education, help with eating disorders, provide advice on childhood and sports-related nutrition, assist patients with their weight management goals, and help patients deal with complex digestive conditions. Right in the office, licensed therapists perform routine mental health screenings and assessments while also engaging in short or long-term psychotherapy, and coordinate with Avance psychiatrists to manage medications. Psychiatrists are ready to help with substance abuse, depression, anxiety, chronic pain and many other conditions.

All the healthcare providers anxiously await the day when construction is complete on the practice’s new medical offices located on Kings Drive, near Target in Midtown Charlotte. Meanwhile, I can reach my PCP when I need him for advice, and feeling optimistic we will all benefit from better, more efficient and convenient healthcare delivery by some very good doctors leveraging Avance’s process and technical innovations.

I leave you with the wit of Dorothy Parker, the subject at hand: “Money cannot buy health, but I’d settle for a diamond-studded wheelchair.”