Just Say Yes! (to Private Practice)

By David Kopacz, MD
“My first word of advice is this, say yes. In fact, say yes as often as you can. Saying yes brings new things. Saying yes is how things grow. Saying yes leads to new experiences, and new experiences will lead to knowledge and wisdom. Yes is for young people, and an attitude of yes is how you will be able to go forward in these uncertain times,” (President of the University of Connecticut, Michael Hogan’s 2009 commencement address, quoted in “How a New Jobless Era will Transform America, by Don Peck, The Atlantic Monthly, March 2010, p. 48).

Doctors are a pretty conservative bunch. We get to where we are by saying no to many things that are a lot more immediately enjoyable than studying biochemistry. It can and has been said that doctors are a risk-averse group. Why then would any physician in their right mind say “yes” to private practice when there are no financial guarantees, no colleagues, maybe even no employees, no 401(k), no one paying your malpractice insurance, maybe you have some patients, but maybe you don’t even have that!

Why on earth would you say yes to private practice?
Well, for me, it felt like a necessity, and I suppose many adventures start out that way. Read more

Rural Primary Care Denied

Garden Vegetables To Thank The Doctor

Today one of my patients kindly gave me a basket of tomatoes and other vegetables harvested from her garden just this morning. I was touched by her friendly gesture, and surprised because I practice in that urban mecca called Hartford, CT. I’m not sure how many productive gardens there are near me (not to mention that few tomatoes have survived the blight wiping out the tomato harvest in Connecticut this summer).

Reflecting on my day during my drive home, I recalled a wonderful and eye-opening family practice rotation during my fourth year in medical school (1987) to fulfill the AHEC requirement. I lived with a family practice physician’s family in a small central Ohio farming community for one month. Everywhere she went, I went. I scrubbed in and watched her deliver babies. I observed her examining endless patients in her office until early evening many days, helping or assisting when I could, and then went to her home for dinner before crashing into the spare bed in her guest room each night to sleep. Her family welcomed me, as did her many patients.

Maybe Doctors Feel Like Celebrities in Rural Communities (but are too humble to admit it.)

By the end of the month I was recognized and greeted as “doc” by people I passed on the street as I walked to the post office or corner store (pretty cool experience for a new doctor), and I couldn’t help but smile and feel lucky to be there. These patients often brought my hard-working preceptor vegetables from their garden, or a freshly baked pie, or a scarf knitted just for her. Clearly they welcome their doctors into their lives as another family member.

The family practice rotation accomplished its goal of exposing a city boy to rural primary care medicine. I didn’t even think about the logistics and practice management aspects of my preceptor’s practice, so different from others I had seen up to then, or talk to her about her salary. She mentioned she loved the “life of a country doctor” and “don’t consider it if you want to make a lot of money”. Practicing medicine for the sake of practicing medicine, and being such an important part of these patients’ lives and families, was definitely appealing to me.

What Do You Mean You “Want To Be A Country Doctor”?

When that rotation ended, and I returned home to my reality, I was convinced I would follow in that inspiring family physician’s footsteps and hang up my shingle in a small rural town someday. Alas, it was not to be. For reasons you can guess, trite reasons to some degree I’ll admit in retrospect, I was tempted by the fruit of other specialties and ended up denying my dream of a rural primary care practice. It was the right decision for me then, and I enjoy my medical practice now, but I still remember that very special experience in small town America and sometimes even let myself wonder how my life may have been different had I chosen that career path.

A basket of garden vegetables brought it all back for me today.

Ideal Medical Practices

In my constant searching and researching for useful information to share with my fellow physicians in private practice, I have found a number of useful and interesting blogs and websites which I will share with you from time to time.

Recently I discovered the blog Ideal Medical Practices which is a group or collaborative blog (like I’m working to build here at PrivatePractice.MD). In their own words, the authors state their blog’s purpose is “to pursue, support, evaluate, and educate others with regard to delivering superb health care in a vital and sustainable environment. ” I share that goal!

Currently they are sponsoring a blogging contest for participants at their IMP Camp in Seattle, WA August 14-15, 2009. Participants will blog at the camp about their concept of an ideal medical practice.

Go check it out. I think you’ll find it as useful and interesting as I have!

Welcome To The Inaugural Edition of PrivatePractice.MD!

Welcome to the inaugural edition of PrivatePractice.MD! This community of doctors and the expert advisors who help them will be your resource to running a more efficient, high-quality and more profitable private medical and healthcare practice. Read more

Why Medicare Is Not The Enemy

As a billing service, I come in contact with many insurance plans on a daily basis. Every year, I have my favorites and the ones that I dread. In all the years I have been in this business, the latter change from year to year (I always have at least one on my hot list that gets my ire up); Medicare comes closer to being one of my favorites and I have had many discussions defending my opinion. Read more

X Prize for a New Health Care Paradigm

The X Prize Foundation has announced a $10+ Million prize to the person or group that creates a fundamentally different US healthcare delivery system.  I think the private medical practice community can win this prize!

In the description directly from the X Prize website it states “This first-of-its kind competition will focus on reinventing the health care system in a bold, measurable and scientific fashion to catalyze dramatic improvements in health and health care value in the United States. The Grand Challenge for the Healthcare X PRIZE is to create an optimal health paradigm that empowers and engages individuals and communities in a way that dramatically improves health value. The proposed prize is designed to improve health value by more than 50 percent in a 10,000 person community during a three year trial.”

The rest of the details can be found on the X Prize website if you want to start imagining how your ideal system would function.

Several private medical practices located relatively close in one region could easily create and treat a community of at least 10,000 patients. These practices could pool resources and create a microcosm, a medical utopia of sorts, along a new paradigm to show that patients received comprehensive care (including preventive care and education), while the small business community of private medical practices also thrived. We have to think big ideas in this uncertain time, and come out stronger and better. The X Prize might provide the impetus for positive change. What do you think? Can we private practice docs pull this one off?

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