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Saturday, February 20, 2010

New Look

The weather is starting to warm up a little. Spring is in the air. It was about time I spruced up the place.

But mainly it was because the old commenting system I used (Haloscan) went kaput, and I wanted to implement Blogger's commenting system in its place. All the old comments got trashed (sorry) but I had no control over that. Give the new layout a spin. Make some new comments. Click on some links. Go wild while we're waiting for healthcare reform to happen. Yep, any time now.

NCQA wants your opinion

The National Committee for Quality Assurance, better known as NCQA, wants to know what you think are the most important features are of the Medical Home. Go to this link and tell them.

Personally, I thought these listed features were all important, but narrowed it down to my top 5:

  1. wait time
  2. seeing the same doctor or nurse
  3. listens and answers your questions (well, duh!)
  4. knows you well
  5. access to help without making a visit
Some of these seem so basic, it makes me wonder why they even have to ask.

Wednesday, February 17, 2010

Happy Anniversary

Ben Chan, a family physician, has just opened his new solo practice and writes:
It has been 8 years since I read Gordon's article. Now, I am sitting in my office in this opening day, waiting for the first patient to call and make an appointment. So this is what you all went through. Emotionally, it has been like a roller coaster ride. At one time, I am happy that I made this tiny leap. On the other hand, there are times when I kick myself and ask, "What are you doing?" For now, only time will tell. At least, at the end of my career, I can tell myself that I tried!
Coincidentally, it was 6 years ago today that I first opened my little office for business. I remember the open house I had on Valentine's Day 2004 to celebrate my new solo venture. We handed out chocolates and flowers and ordered way too much food. On my first day of business, I sat by the phone and waited and waited . . . and waited. I felt like I couldn't leave the office because what if somebody called? I was afraid of missing them. But no one called. 

The days passed, with no patient in sight. I knew it would be slow to start but yeesh— not this slow. I brought no patients with me from Kaiser and was new in the medical community. I placed some ads in the local paper. I asked friends to tell their friends. It was lonely. 

Finally, 2 weeks later, on March 1st, I saw my first patient. I saw him at 8PM, and he had no insurance and forgot to bring cash. I remember that he felt embarrassed and offered to go to the ATM up the street so he could pay me. I felt bad because it was raining, but I thought to myself, I did just provide medical care for him and if he didn't pay me now, who knew when I would ever see him again? Would he even come back after he left? 

He did come back and paid the $40 for my first visit. Six years and 5000+ visits later, I just did the 2 month old well child check for his 2nd son. He still doesn't have insurance, but I'll always remember who my first patient was. So will Ben. 

And Ben shouldn't belittle his accomplishment by referring to it as a "tiny leap". It is a huge leap of faith to leave the safety of a traditional group practice and go it alone. Some would say, it's crazy. But it's like that old Apple commercial:
Here'’s to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They’re not fond of rules and they have no respect for the status quo. You can praise them, quote them, disagree with them, glorify or vilify them. About the only thing that you can’t do is ignore them. Because they change things. They push the human race forward. While some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think that they can change the world, are the ones who do.
So here's to many more physicians like Ben who are trying to change THE world by changing THEIR world. It has certainly changed mine for the better and, I hope, the lives of the patients whom I have seen in my little micropractice.

Go get 'em, Ben.

Wednesday, January 20, 2010

This would be funny except that it's true












From Candorville.com

Unfortunately, the Republican win in the Massachusetts Senate election probably means that these kinds of shenanigans will keep happening.

Tuesday, January 19, 2010

Rochester, NY: IMP Capital

Anyone who has been following my blog won't find this article from today's Rochester Democrat and Chronicle unusual:
When Dr. Linda Lee sees patients, she brings them from the waiting room, typically spends a half hour with them, cleans up the exam room and submits the insurance claims online. She's the one who returns phone voicemails, and she gives patients her cell phone number for urgent after-hours needs.

She has no nurse, no billing staff and no answering service. She only has a part-time secretary to digitally scan records that still arrive on paper at her paperless office.

The Rochester family physician's 5-year-old, low-overhead, solo practice is a stark contrast to the hurry-up, assembly-line format she found in large medical practices. "You basically had to see a patient every 10 minutes," said Lee. "How can you address the patient's medical problems in that short a time?"

What is unusual is that this article points out that there are 8 Ideal Medical Practices in this local area, which is frankly amazing considering how few IMPs there are in the entire US.

Other IMP clusters are located in Seattle, Portland (OR), Southern California, Albuquerque, Albany, St. Louis and New York City.

For a list of IMPs around the country, go to www.impmap.com. Don't forget to use the zoom in/out controls to take a closer look.

Sunday, January 10, 2010

Those Who Can't Blog, Link

So even though I haven't been keeping up with my blog, I thought I should point out some excellent bloggers who not only manage to write something on a regular basis, but also have something meaningful to say.

The Ideal Medical Practices Blog's focus is on the myriad problems facing America's healthcare system and especially its beleaguered primary care physicians, and what can be done to bring about real change.

Dr. Malia Reckons are the insights and thoughts of a solo family doctor in Rochester, NY, whose practice model is very similar to mine.

I just discovered that The Examining Room of Dr. Charles has re-opened after a two year absence. "Dr. Charles" is a unique voice in the blogosphere, whose tales about medicine and life in general are more like finely crafted works of art. I highly recommend his site.

Finally, while not a blogger, Dr. Atul Gawande is clearly an excellent and insightful writer who also happens to be a general and endocrine surgeon. His recent article for The New Yorker echoes my thoughts on how no single solution to our healthcare crisis is possible, namely because nobody knows which approach will work. He argues that, like in America's early agricultural industry, pilot programs may help guide us out of our national dilemma. After all, when you don't know which way to go, why not try several different directions at the same time instead of just one?

Monday, January 04, 2010

When News Topics Collide

Image

From Sage, Ink at The Atlantic.com.

Happy New Year!