There seems to be a never ending debate about healthcare in the United States. In this debate there are four main parties. The patient. Government. Insurance companies. And doctors. Despite their differences of opinion, all of these parties claim to agree on one simple thing. And that is, medical decisions are best made by doctors. Despite that, the fact is we have a healthcare system that is anything but simple, and that often filters medical decision making through a financial lens. In 2004, a group of doctors in Lafayette launched a business that would concentrate as much of the medical decision making as possible in their hands. They opened their own hospital. Lafayette Surgical Specialty Hospital is a 20 bed physician owned hospital with 8 operating rooms, 3 procedure rooms, and a caseload of 8,000 patients a year. The CEO of Lafayette Surgical Specialty Hospital is Buffy Domingue. If you live in a city or even a reasonably populated small town, the biggest problem you have seeing a doctor is getting an appointment. But if you live in a more rural setting, or maybe you work offshore on an oil rig, getting to see a doctor can be anything between a severe hardship and an absolute impossibility. A Lafayette medical company, Xstreme MD has solved that problem. Xstreme MD lets you see a doctor no matter where you live or work. All you need is an internet connection and Xstreme MD will put you in a virtual doctor s office with whichever type of physician or specialist you need to see. Since its inception in 2009, Lafayette based Xstreme MD has become one of the country s leading exponents of remote health care. Xstreme MD s Chief Medical Officer is Dr Michael Odinet. Peter Ricchiuti, professor of finance at Tulane University and host of Out to Lunch New Orleans, sits in for Aileen Bennett on this edition of Out to Lunch. Photos at Cafe Vermilionville by Lucius Fontenot.