Hands On Medicine Closure

Thank you for the honor of serving as your primary care home for nearly 20 years. After careful consideration, we have made the difficult decision to close our practice, effective October 18, 2024.

We understand the vital role we have played in your healthcare, and ensuring a smooth transition and continuity of care for our patients is our top priority.

If you have an appointment after October 18 and before January 1, we will do our best to reschedule your appointment before our closure. All appointments after January 1 have been canceled.

You can request a copy of your medical records here.

Letter from the Medical Director: Gratitude

August 9, 2024

Greetings! On October 18, Hands On Medicine will lock its doors, no longer take appointments, and employees will leave for other professional pursuits (stay tuned for updates on the website). Hands On Medicine has been the largest accomplishment of my life, second only to being a mom and foster parent. To say this was a difficult decision is a gross understatement.

Hands On Medicine has treated tens of thousands of people over our nearly twenty years of business. There are ~500 patients that have been with the practice for over fifteen years. Some of you are adults that grew up in the practice. Some of you moved away and reestablished upon your return. Many of you are multigenerational families. A special number of you followed me from a previous practice and have been here from the inception. To each of you I share my gratitude and love. Providing healthcare through illness and wellness, all stages of life, hard times and happy occasions has been an honor in the deepest sense of the word. Thank you for trusting me and my staff with you and your loved ones.

Hands On Medicine has weathered many challenges, from the recession beginning in 2007 to the worldwide H1N1 influenza outbreak to the devastating COVID pandemic and subsequent economic and political turmoil. While I have managed the helm with seemingly great success, I could not have done so without my amazing staff! Several of you have been my ride-or-die for a tenure uncommon in contemporary times. Over the past two decades I have been graced with many dedicated employees who juggled their personal lives while maintaining professionalism at work. We have witnessed one another grow and change through beautiful unions, joyous births and great accomplishments. We have also held space for one another through shocking personal tragedies, some nearly devastating and far too frequent. Hands On Medicine staff, you are all deeply beloved family to me. I wish each one of you a brilliant future, brighter than you presently imagine.

If you, the patients and staff of Hands On Medicine, see me in the neighborhood, please say hello. And if we never meet again, know that I will forever think fondly of you and never forget the individuals that made Hands On Medicine a true medical home. There is no place like Hands On Medicine, but I hope you find the quality healthcare and employment you deserve as soon as possible.

Health and Happiness,

Shelda R. Holmes, FNP

Letter From the Medical Director: The Reality Behind My Decision To Close

September 1, 2024

Hands On Medicine has been a steadfast presence in N/NE Portland and the lives of thousands of individuals and families for nearly twenty years. I founded Hands On Medicine with the mission to provide high-quality personalized healthcare to individuals and families in my neighborhood, create jobs that value quality of life, and to make a substantial contribution to the overall health of our Portland communities. I can proudly state Hands On Medicine has successfully met this mission and more. However, this has come at a great cost.

The US Corporate Health Industrial Complex is a deeply flawed system full of mismanaged resources and exceptionally high stakes. Despite these tremendous obstacles, Hands On Medicine has managed to provide care that exceeds standards of practice and common expectations. Over the years we have insulated patients from the challenges of providing care everyone deserves and that we can be proud of as providers of care, not providers of insurance. I have decided that to continue providing such high-quality care with ridiculously low compensation and high liability and conflict is not fair to myself or my employees. I have come to see that subsidizing the broken system does not improve it. In fact, buttressing the broken healthcare system only serves the system itself, hiding its flaws and misleading patients.

Staff spend countless hours answering questions insurers have artfully evaded. Providers spend disproportionate clinical hours hunting down medications in short supply because corporate pharmacy staff cannot be bothered. The hours staff spend in prior authorization purgatory to get patients the care we know they need begins to add up to days, weeks and years. But the inefficiencies do not stop with private corporate healthcare. The State of Oregon’s Medicaid system is as unsupportive now to the clinicians and small clinics that make up its backbone as it was when I started Hands On Medicine nearly twenty years ago.

The entire time I have owned Hands On Medicine, I have fought on many fronts: as a primary care provider in a hierarchy wherein specialists are kings, as a nurse practitioner in a physician-dominated field, and as a small business owner surrounded by big box medicine. Primary care that is preventative and holistic is completely taken for granted. Nurse practitioners continue to be viewed as “less than” by the medical establishment that sees licensure before credentials and experience. There are fewer and fewer small family practices and true neighborhood clinics in our country, and for clear reasons. The road to here and now was full of obstacles and the forecast is worse: more private equity purchases, huge system mergers, and an exponential squeeze on the little gal.

I write these truths because people should know, our patients should know, and we all need to be doing something about it. This broken healthcare system does not afford people the high-quality services patients have come to expect at Hands On Medicine: 30 and 45-minute appointments, less than 3-day notice medication refills, insurance plan education, 24/7 access to clinicians or a front desk staffer that knows your name and recognizes your smile. What Hands On Medicine has provided is beautiful and authentic, but unfortunately it is completely unsustainable.

Though I have chosen to close Hands On Medicine, I did attempt to sell the practice in hopes that staff and patients would have a choice as to where to obtain employment and healthcare, respectively. I quickly learned that there are fewer individuals and small groups going into family practice then when I began this lonely two decades ago. Most mergers, acquisitions and expansions are among the usual suspects- large hospitals, urgent care chains, huge insurance companies, private equity firms and other big box or online retailers. I refused to sell to an agency that would dramatically change the care our patients receive and soil the legacy of the hard-working employees that made Hands On Medicine the clinic it is today.

As I step off this soapbox, I would like to conclude with a request. If you care about the value of your healthcare and tax dollars, and care about the health of yourself and your loved ones and neighbors, let’s have a dialogue about really big changes like universal healthcare, decentralizing corporate healthcare and insurance, and supporting hands-on care where we all need it: within our families and communities.

Our Mission

“At Hands On Medicine, we approach achieving health and wellness through nurturing the mind, body, and spirit within individual, family and social contexts.”

“Patients are encouraged, expected, and empowered to take an active role in their healthcare through integrated, multidisciplinary collaboration.”

Hands On Medicine’s Goals

Empower patients, prevent disease, collaborate on interventions, promote healthy lifestyles, and teach disease management; Contribute to and sustain healthy families and communities through long-term clinical practice, policy creation, and political advocacy; Provide living wage employment, help achieve professional aspirations, increase knowledge base, and create a healthy work environment.

Health Care Reform Brief

We at Hands On Medicine full-heartedly support health care reform. We believe health care should be a right. Health care access should be granted equally to everyone. We believe each of us should responsibly use the health care system and treat our bodies, families, and environment with care so that health is attainable. Unfortunately in the United States health care is not a right. Health care is provided and managed largely in a for-profit model. Hands On Medicine is doing the best we can to advocate for our patients, create a better health care system and improve the public health infrastructure. We are simultaneously attempting to provide a living for our staff, families and selves through our work as health care providers and clinic owners.

Primary care providers are among the hardest working and most dedicated medical professionals. Many, like us, could have chosen to enter a more lucrative field of medicine. Our love for our work far exceeds the financial benefits we may have received by taking another road. Owner Shelda Holmes is fond of saying “I do it for the quality of life, not the money. I want to contribute to my family and community in ways I cannot in other practices.” Regardless, we have faith that the state of health care management in our country will change for the better and thereby the health of communities will also improve.

Environmental Commitment

We use reusable cloth gowns (imagine no uncomfortable paper gowns). We do laundry and clean using the least hazardous materials possible. We sterilize the equipment we can for reuse via an autoclave. We cycle! We recycle! We use an electronic medical record system instead of paper charts. We are always thinking about how we can reduce our contribution to medical waste. Go here for more information regarding this unfortunate side-effect of medical advances.