Friday, November 09, 2007

Medpundit Goes Micropractice! (sort of)

Medpundit had a taste of the micropractice way of life, but doesn't sound like she enjoyed it. That's probably because she was seeing her usual amount of patients with less help (ie. short-staffed) rather than the smaller volume (less than 10 patients/day) that most micropractices enjoy. So all the pain but none of the joy of a micropractice = bad experience.
The truth of the matter is that micropractices work only for micropopulations. Most people who practice that way limit themselves to 200-500 patients, whereas traditional practices handle 1500-2000. So which is better for the public good? A practice that can treat more patients and provide jobs or one that sees few patients and has no employees?

I don't know who decided that 200-500 patients is a "micropopulation" while 1500-2000 patients is a "normal" population. When I was at Kaiser, I knew some FPs who had patient panels of 3000, which I thought was ridiculous. Is that a macropopulation? Wouldn't it be more efficient to have a patient panel of 10,000 and have physician extenders do most of the grunt work while the physician supervises?

The truth of the matter is that micropractices work only for those who value a slower-paced, unrushed, more thorough patient-physician encounter. Not everyone wants to eat at McDonald's; some people prefer the little old-fashioned restaurant down the street. Not everyone wants to be a patient in a traditional practice where they wait a traditional 30 minutes for their traditional 5 minutes with the doctor who traditionally is running behind schedule.

I maintain that it is better for the public good to have happy doctors and happy patients pioneering a new practice model which can be an alternative to the current model where both doctors and patients are too often unhappy.