Monday, September 13, 2004

From little acorns grow mighty oaks

Thanks to the links from MedRants and MedPundit, I've gotten more visitors in the past 3 days than I've gotten in 3 months. If only it were that easy to get patients into my solo practice.

My last entry talked about being interviewed for a newspaper article about my "Gordon Moore type" of solo practice. Here is the article that came out 4 days ago. The newspaper has a circulation of 35,000. The article was also published in a sister publication which has a circulation of 48,000. Since the article came out I've had 6 calls for appointments generated by the article, 2 calls from Kaiser patients who are unhappy with their care and want me to see them at Kaiser (I had to explain that I cannot do this), and 3 other general inquiries: what are my hours? do I accept HMO? (no); and one letter from a patient documenting how the last 10 doctors she saw couldn't help her but she was hoping that I could.

12 responses out of 83,000 potential readers. And that's not counting their websites. What this tells me is that there isn't as pressing a demand for a old-fashioned country doctor as I thought. Or maybe people just don't read the newspaper very carefully. Or maybe they didn't know how to contact me, since no contact information was included. The ones who found me said they just looked me up in the Yellow Pages.

But that's OK. I was plenty busy today. If I had 20 patients call for appointments, I don't think I could've accomodated them. I can't complain since it didn't cost me anything to be interviewed. I think that there is an abundance of primary care doctors in the suburban area where I live. Plus I think that as much as some people complain about the lack of accessibility to their doctors, it's probably good enough for most people. Of course, I may continue to get calls later on. Some people may have clipped that article and saved it for future reference. And the people I saw today will hopefully tell their friends and family about the doctor who answers his own phone and spent an hour with them. This is about planting seeds for a future harvest.


Since starting this blog, I've found more and more medical blogs out there. In fact, if I read all the medical blogs from this site, I wouldn't have time to do any work.

The subject of blogs came up in a recent discussion about how to disseminate information about a new diabetes project being sponsored by the California Academy of Family Physicians. Well, consider this the first seed.

As part of the CAFP's effort to bring the Future of Family Medicine Project recommendations to fruit, it has decided to try and tackle the improvement of diabetes management. In our focus group last week, we decided that just about every family doctor knows what good diabetes care entails, we just need some help tracking and following up on our patients.

At Kaiser, they are ahead of most doctors. They actually give a printout every 3-6 months to each primary care doctor listing their diabetic patients and what percentage of them have had their retinal exams or microalbumin done, and what percentage of patients have their HbA1C in range. However, it is still up to the individual doctor to then contact any patients who may not have an optimal lab or may be missing labs completely.

We discussed the possibility of creating and distributing software to family doctors that would offer "one-stop shopping" in diabetes management. It would have a database which can track various parameters and allow you to see which patients are due for various labs or tests. The program would also be able to generate e-mails to patients reminding them when it is time to come in for a diabetes check-up. It would have links to up-to-date patient education material that can be e-mailed or given to patients to assist their self-management. In return for providing this software, the CAFP would get information. The database would be able to upload depersonalized aggregate data into a central database to help provide pooled statistics that can later be used to document (hopefully) superior diabetes care.

So hopefully this seed of an idea grows into something big.

Just as I hope this blog can plant some ideas into the minds of doctors who might want a practice that isn't too bureaucratic or just plain too busy to care for their patients. Now where's my trowel?