Saturday, September 15, 2007

Not feeling rushed

From the Albany Times Union: "Doctor cuts staff, buys time"

One thing about Dr. John Pramenko's new practice: Patients won't feel rushed.

The 41-year-old family physician is opening one of the region's first micro-practices, a relatively new model in health care that has no nurses, office manager or receptionist. Patients make appointments online, and records are kept electronically.
Without the staff, the practice can operate much more cheaply. And with lower costs, doctors can afford to take fewer patients a day. That means more time for each patient.

"I have colleagues who see 30 patients a day," Pramenko said Thursday. "When you're seeing that many patients, it's really hard to have a good relationship. Every visit, you have your hand on the doorknob."

These days, in my micropractice I rarely ever talk to patients with my hand on the doorknob.
The micro-practice movement began in 2001 with a Rochester doctor named Gordon Moore. Like Pramenko, Moore had been bothered by his limited time for patients. It was his idea to use computer technology to create a self-sufficient practice.
"A lot of doctors are becoming increasingly disenchanted in what they're experiencing," Moore said. "I was about helping patients. A lot of things happening around health care have made it very hard to help patients. We don't have time."
Since he opened the first micro-practice in Rochester, Moore has acted as a spokesman for this new style. Now he sees patients only a quarter of the week, and uses the rest of the time to help other doctors set up similar practices around the country.
Today, more than 100 exist around the United States, including Dr. Padma Sripada of East Greenbush. A computer list-serve on the topic has 475 members, with doctors signing up at a rate of three to four a day, Moore said.

Drs. Pramenko and Sripada are both on the IMP Map.

What makes this even more interesting is that only 2 weeks earlier, the same newspaper published a story about a family doctor closing down his 26 year practice due to poor reimbursement. His office is located about 45 miles away from Dr. Pramenko.

Sometimes I wonder if the Ideal Micropractice movement will really be able to bring about meaningful change in America's healthcare system, or if we're just part of primary care medicine's slow death spiral, and all we are doing is delaying the inevitable. Whatever, whichever, I'm not going down without a fight.