When the team internist for the Los Angeles Clippers isn't traveling with the team during playoffs, he's a proponent of allopathic medicines and can be found at his practice, which uses a hybrid concierge model of delivering care.
Steven Krems, MD, maintained his poker face. He had just been asked by one of his partners at Access Medical Group for assistance in carrying out the duties of team internist for the Los Angeles Clippers basketball team. Krems didn’t want to let on how “crazy exciting a concept” it was for him.
Several years later when the partner retired, Krems inherited the job.
“I don’t travel with the team during the season, but I do during the playoffs,” Krems explains. “It’s totally awesome; totally neat.”
And appropriate, since it was athletics that originally drove Krems to focus on a career in medicine.
A body of work
Krems says that as a teenager he was always interested in how the human body works from an athlete’s point of view. He was fortunate to take an anatomy class in high school with “an amazing teacher; very inspirational.” Krems was hooked.
In college, at the University of California at San Diego, he continued gravitating toward the biological sciences, then applied for and was accepted into the Tulane University School of Medicine.
And he remained extremely grateful to his high school anatomy teacher.
“About 10 years ago I was working and happened to meet [the teacher’s] daughter,” Krems recalls. “I shared my story with her, and that was really gratifying. It was a nice, small world experience.”
Keeping options open
In addition to being Board-certified in internal medicine, Krems is also certified in medical acupuncture and is an expert in herbal therapy. His interest in those more non-traditional forms of medicine started even before he attended medical school.
“Coming from southern California, we’re sort of exposed to this stuff anyway, and I realized there was more to offer than just strict allopathic medicine,” Krems says. “My sister, who is two years younger than me, had to have some surgery when she was relatively young, and I realized that the way the doctors communicated to my parents and myself at the time was kind of limited. So I just realized there were other options. I didn’t necessarily know what they really were, but because of that experience I just kind of kept my ears and eyes open, and was just open to stuff outside of western medicine.”
His admission essay to Tulane included that “openness,” and he was advised to remove it from the essay or he might never be admitted to medical school. He did so, but maintained an interest in alternative treatments. And when he returned to Los Angeles for his residency in internal medicine at the UCLA/Wadsworth VA, he received approval to design a month of rotation spending time with alternative practitioners.
“I saw some amazing things,” Krems recalls. “That kept me interested in looking at alternative therapies. And as I saw things that seemed to be very effective, I tried them in my practice. I just look at it as I have a larger toolbox, a larger armamentarium, than regular prescription medication.”
He points to tools outside of the allopathic toolbox that are very effective for treating conditions like ulcerative colitis or Crohn’s disease. And because these therapies are a little different than what everybody else is doing, Krems feels he has contributed something very positive to his patients’ care.
Krems’ openness to change prompted him to recently move to a hybrid concierge model of delivering care. Part of the decision process involved self-preservation. (“My days are just so crazy busy,” he explains.) But it was also about being able to spend more time with patients, less time on paperwork, and provide better quality care.
“Most of us who go into internal medicine, we go into it because we like longitudinal care — caring for people over the long term,” Krems says. “And honestly, as opposed to what TV would have you believe, we don’t really take care of people by getting a CT scan and a PET scan and an MRI. We actually take care of them by getting a good history, and taking the time to talk to them and hear what’s going on. That’s the most important part.”
Krems was skeptical about going to a full-scale concierge model, but when he learned about the hybrid model through Concierge Choice Physicians, that seemed to be the best of both worlds. And once a survey of his patients revealed their receptivity, he decided it made sense.
“The bottom line is, if I’m going to fly to Columbus, Ohio, I can fly first class, or I can fly coach,” Krems explains. “We’re all going to get to Ohio at the same time. It’s just we make a decision — do we want to pay extra and get the service of first class, or do we want to go in the back and read a book along the way and not have much leg room? Either way, we get there and we get there safe and sound.”
A busy life
Despite his busy practice and serving as team internist for the Clippers, Krems makes certain to carve out a portion of his schedule for his teenage daughter who competes on a travel volleyball team.
“It’s a crazy life,” Krems says. “But I can’t think of anything more enjoyable than doing things with my daughter. That takes precedence.”
Krems doubts that he has missed more than a handful of volleyball, soccer or basketball games going back to when his daughter was 6 years old and admits that he’s fortunate that he can make his own work schedule.
“If my daughter is traveling and there are tournaments, these are all-day events,” Krems says. “So between matches, I have my laptop, I connect to the office, I get my work done on weekends. In our computer world, you can be remote. That does help. I wish I could say I leave the office and I have nothing to do, but that’s not how it is.”
And he wouldn’t change any part of it.
“It’s a privilege to really get to know people at an intimate level and be able to help them out, whether it’s just educating them about their health, or making a change that helps them live a healthier life and feel better,” Krems says. “When you can really make a difference in someone’s life in that kind of a way, those kinds of instances make all the hard work well worth it.”