Everyone involved in Healthcare wants the same thing, to take exceptional care of anyone who comes for care.  Different Models of Primary Care have arisen over the years. Some work pretty well, others not so well.  All can and must improve.  These configurations are usually in response to agendas not directly related to the interaction between patient and provider.  They may be being driven by finance, technology access issues, or administrative issues imbedded in our current systems.  Sadly, many of these changes have the net effect of depriving both providers and patients of a number of critical components.  These include excellent access coupled with excellent continuity coupled with enough face to face time, allowing us to progressively build upon therapeutic relationship with our patients.  All three are critical.  We all have access to the same books and resources.  It is this time/access/continuity triad that forms the art and helps fashion outcomes that matter to the patient, and helps feed our souls.  This is what prior generations of primary care physicians saw as a given.  Can we still have the rich relationships they enjoyed, practice 21st century medicine and still have a life?

Many Primary Care Physicians feel tired, overworked and underappreciated; underappreciated by all but the ones that matter most, the patient.  We react to forces seemingly out of our control.  Some seek a ‘safe’ haven in employment, others carry on independently, but all seek to do the best job possible for their patients, some while teetering on the edge of burnout.

I decided in 2007 to leave employed practice and give it one more go: to focus on the ideal interaction with the patient, and build everything else around this.  I have found small practice life to be fun and rewarding, providing a fertile ground for innovation and ideas that can be implemented quickly. Over the coming months information will be added about our experience of ‘starting from scratch’.  Is it complicated?  What about billing? What do you mean, giving all patients access to your cell number?  Do you miss that regular paycheck?  We encourage all Primary Care Physicians to ask a simple question;  Is each interaction with the patient as ideal as it can be?  If not, take an active role in how this interaction with the patient is structured.  If it needs to be built, help your organization do it, or do it yourselves. After all, you are the Primary Care expert.


IdealMedicalPractices    If there is one thing I would heartily endorse, it would be to spend some time with these folks. IMPs are a group of hundreds of physicians who question everything, and frequently find that the way things are done in large practice make little sense to physician, or patient. This group has, literally, centuries of collective wisdom about the nuts and bolts of small practice life, from the very practical, to the highly philosophical. Monthly group “calls” and online access to other IMPs is invaluable. Nearly all are physicians who have grown weary of the treadmill and struck out on their own. In small practice, there may be a tendency to feel you are ‘on your own’. This group has filled that void for me, providing a great group of innovative primary care thinkers with which to interact.

HowsYourHealth    Another must for those looking to collect more information, that is actually useful clinically as well as ‘actionable”, in real time. I remember our office needing to do patients satisfactions surveys in the ‘old days’. Our staff would groan and we would receive the results months later, when they were of very limited use. We discussed using HowsYourHealth, but it went nowhere. As a small office, your patients can start using this with little fanfare, no expense and no meetings! An indispensable ‘tool’ for our practice.

The Rebirth of the Solo Family Doc    Once in a while I am heartened to read a piece by ‘physicians in high places’, that echo our feelings and support our successes ‘swimming against the current tide’ of health care delivery. This time the recognition and encouragement comes from Dr. Jeff Sussman, MD. Editor in Chief of the Journal of Family Practice. Thanks Jeff.

Simply Contact Me: Of course, a phone conversation can be well worth the time and effort. I am always glad to share our perspectives with all. Just drop me an email!

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