High and Dry

If I don't answer my office phone for the next few days, it's because my VOIP phone provider (SunRocket) suddenly went out of business. Grrrr!

The problem with being on the bleeding edge of technology is that frequently you get cut.

Now I have to decide if I should go crawling back to the safety of a landline, or take another chance with a different VOIP provider. I'd consider VOIP with my cable provider, but for some strange reason they don't offer VOIP for business users although they do for residential customers.

This recent Google-acquisition looks promising, but they're only in beta. (No financial interest in Google!)

Two More Micropractices

Here's something unusual: TWO newspaper articles about micropractices in one day.

From today's Los Angeles Times: "It's about time, say doctors in vanguard"

In a 150-square-foot tin-ceilinged office in a building that once housed a speakeasy, Dr. Moitri Savard checks her laptop to see whether any patients have scheduled themselves to see her.

Wait, scheduled themselves?

Yes. Savard's patients decide when they want to see her and then let her know by filling in a date and time on a calendar on her website. Patients with no computer access can phone for an appointment.

Savard, 36, a graduate of the Stony Brook University School of Medicine, is in the vanguard of a small number of physicians who are experimenting with a new family-practice business model.

It's called a micropractice.

Savard has no nurse but shares a receptionist with several other solo practitioners and does her own paperwork. Mostly, she runs her office electronically — lowering her overhead because she has no salaries to pay.

And the Idaho Statesman: "Boise physician finds low overhead lets him give patients more time"

Dr. Chris Peine sits behind a desk in his 500-square-foot office. He's alone. The glass doors are dusty and waiting to be wiped clean, but he doesn't have much time to do it today. He is too busy answering phones and e-mails, treating patients, vacuuming and taking out his own trash. Peine doesn't have a single employee.

Peine (PIE-nee) follows a new model of health care called the "ideal micropractice," one of a small but growing number of physicians nationwide who are shucking large offices and big staffs to simplify their medical practices and spend more time with patients.
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Before moving to Boise with his wife in September 2005, he was a physician at a large cash-only practice in Indianapolis that did not accept insurance. He met with a handful of patients every hour, he said, and the lack of face-to-face time strained his relationships with his patients.

"I wanted to really simplify the whole health care experience," he said.

"Complexity interferes with the doctor-patient relationship."

Boy, does it ever. But thankfully, not in a little slice of Queens and Boise.

A Taste of Their Own Medicine

To this day, I still remember what it was like having a rectal exam done on me by a fellow classmate in medical school, and I think it has made me a better doctor. No camping out by the prostate for me. I think that is the rationale behind this idea of having resident physician get a taste of what it is like to be a hospital inpatient.

Clad in hospital gowns and assigned various ailments, six doctors at Presbyterian Intercommunity Hospital were poked for blood tests and had their vital signs checked regularly when they spent a recent night as patients.

"I think it's a really good experience for us," said Dr. Megan Stone, who was attached to a heart monitor for "a sudden onset of chest pains."

The fake illness was part of a special orientation for resident physicians in the Whittier hospital's Family Practice Residency Program. Six doctors from the program pretended to be patients and stayed overnight Sunday to get a taste of what it's like to be a patient, said Dr. Patti Newton, associate program director of curriculum.

"It will stick in your head if you experience it, rather than hearing a lecture," she said.

But if you really want doctors to have more compassion for patients, make them schedule themselves for an annual physical (without telling anyone they are a doctor) and see what it is like.

But the most effective way to improve healthcare in the US: require the President and all members of Congress to use Medicare.

EMR on iPhone

Just what I need: an excuse to get an iPhone. "But it's for work, honey! Honest! Only $5999!"

"Hmmm, okay, maybe just the iPhone then?"

Well, it's worth a try.