Old Fashioned Touch

From The Olympian in Washington State: "Old-fashioned touch: Micropractice helps doctor humanize modern medicine"

Dr. Marius Laumans strives to run an old-fashioned medical practice with modern-day conveniences.

Need a same-day appointment? Patients can go to his Web site, check his availability and schedule one.

Wondering if an over-the-counter allergy drug could mix poorly with prescription medication? All of Laumans' patients have his cell phone number and e-mail address and are encouraged to use them anytime.

Too sick with a stomach bug to get out of bed and drive to his office? Not to worry, he makes house calls, too.

"Thirty years ago, this was what a regular practice looked like," Laumans said.

The 34-year-old family physician is one of a growing number of doctors who are opting to go solo - without the support of receptionists, nurses, medical assistants, billing clerks and cleaning staff.

Dr. Laumans is indeed part of a growing movement of IMP (Ideal Medical Practice) doctors that seeks to improve quality of care as well as quality of life for patients and physicians alike. However, this article perpetuates the old concept of "micropractices" being completely solo-solo operations. Many IMPs start out without any employees, then add staff later as the practice grows.

And there aren't 500 micropractices/IMPs in the country...yet. But hopefully there will be. To find an IMP, go to http://www.impmap.com.

The Hopeful Future of Medicine

IMP Camp 2008 is underway and full of bright-eyed and bushy-tailed (and even tail-deficient) doctors!

From Soma's blog

I had started my medical practice in Manhattan in the summer of 2006. They say if you can make it there you can make it anywhere…Oh boy is that true. I started my business before I even knew the existence of the IMP group. I didn’t realize that the same concepts and the similar reasons why I wanted to go into business for myself was why several other physicians all over the country did the same. Most of the topics at the conference are things that I have already been developing in my own business. The spirit of the people is what gives me inspiration to continue what I am doing. Some have been in business longer than I have, some work in areas that are considered to be dead-zones for effective health care. But they continue. They get over the hurdles, take every day one day at a time and remain true to their souls. The magic of this is this is something that you cannot learn in medical school. It already has to be there. And most of the people here have it.

Speaking as one of those "dead-zone" doctors, I agree with Soma's sentiments about the enthusiastic spirit and idealism of the 80+ attendees. We want to save the world, one patient at a time.

IMP Evolution

From the June 2008 issue of Medical Economics, "Small practice evolution: The medical micropractice":

Every so often, a new patient of internist Jean Antonucci in Farmington, ME, looks puzzled when the doctor herself—and not a medical assistant—walks into the waiting room and escorts him to a 125-square-foot room.

In that room, which looks out on pine trees and a stream, Antonucci takes vital signs, asks the patient what's bothering him, diagnoses and treats that problem, and collects the copay. By the time the patient leaves, he realizes that Antonucci is truly a one-woman show.

"I really don't need staff," says Antonucci, who rents the space from another physician. "I'm amazed at how well this method works."

The method is known as a micropractice, and it defies the conventional wisdom of practice management experts who urge doctors to boost their productivity by delegating nonphysician chores. A micropractice doctor typically works without employees in a space that's drastically smaller than what the average soloist has. Such austerity reduces the customary overhead by 40 to 50 percent, thereby lowering the break-even point and enabling micropractitioners to spend more time with fewer patients.

Speaking of evolution, the official name is now "Ideal Medical Practice" or IMP, and not micropractice. That's because you don't have to be solo/small to achieve ideal health care.