Tuesday, March 22, 2005

What's Old is New Again

When I embarked on my journey towards a solo practice, I thought I was trying something revolutionary. Since then, I've found some articles on the internet about the revival of solo or old-fashioned medicine. When I read them, I realized that others have shared the same goal of what medical practice should be like, to a time when people mattered more than money, and doctors weren't too busy to care. Several of these articles credit the dropping of the middleman -- insurance companies -- to make their practices a success.

Here's a recent article about a physician's success at going solo.
The popular perception is that solo practitioners are stuck in the past-carrying black bags and wearing mirrors on their foreheads. In fact, says Joseph Heyman, M.D., physicians who practice solo have to be on top of the latest technology to make it work. Heyman, a gynecologist, runs his own practice in Amesbury, Mass., where patients can ask for appointments and medications at his Web site. Since April 2001, he's maintained an electronic medical record and prescribed electronically. He runs a paperless office and batches his own billing at the end of the day. The advantages? "I soon realized that no one else would be as unrelenting as I am in keeping insurance companies honest," says Heyman, who left group practice. With only one employee, Heyman can keeps costs down while making a decent living. He also has more time to spend with patients. The maverick practitioner chats about the merits of going solo.


From Businesweek: Doctors Who Make House Calls
DECEMBER 10, 2004

Tired of conveyor-belt medicine, a growing number of physicians are finding a viable market -- and better results -- in old-fashioned home visits

Doctors aren't afraid to say it: Practicing medicine has never been more difficult. General practitioners are under intense pressure to see dozens of patients daily. Because of an overburdened health-care system, many say a once-personal business has shifted to a hand-on-the-doorknob, quantity-over-quality model.


The doctor is out: Local physicians shun HMOs for new -- or some would say old -- ways to practice
March 05, 2003

In the 1990s, California was heralded as a leader in the charge into managed healthcare. Today, California physicians are sounding a retreat.

Or so concludes Dr. Kevin Grumbach, a UCSF professor and director of the Center for California Health Workforce Studies. In December, he and a team of researchers polled California doctors that found that only 58 percent of them physicians interviewed would take a new patient who carried private HMO insurance, even though more than 90 percent were accepting new patients.


From Minnesota Public Radio: A new "old-fashioned" doctor
In an age when many patients complain about paying too much money for too little time with their doctors, a central Minnesota physician is trying something different. Dr. Susan Rutten considers herself an old-fashioned country doctor. Rutten makes house calls, and her patients pay in cash. And even though she doesn't take insurance, she provides affordable healthcare by keeping her costs low. Dr. Rutten hopes her work inspires other doctors to consider a more patient focused approach.


From CBS News: Old Fashioned Doctoring

Jan. 22, 2001

Some doctors say they're sick of insurance companies. So, in an effort to provide better patient care, they're turning back the clock, CBS Health Contributor Dr. Emily Senay reports.

It's no secret that many patients have had it with their HMOs. But so have a lot of doctors. In Denver, Dr. Senay visited a couple of renegade doctors who call their practice HMNo. Husband-and-wife medical partners Dr. Jonathan Sheldon and Dr. Heather Sowell make house calls, spend plenty of time with their patients, and answer their own phones.

And finally, a story about a practice that didn't survive, but should have.

Is there room for the old-fashioned medicine?
Early this month, a young pediatrician got the surprise of his life. He walked into a Bay Area meeting hall and was greeted by several hundred patients and their parents. "Yay, yay, yay!" The cheers echoed from voices young and old for several minutes. The doctor ducked his head and laughed in delight.


Will my practice end up like the doctor's in the first article or the last? We shall see.