Changing the PrivatePractice.MD Mission

The focus of the discussion on PrivatePractice.MD is changing from this point forward. When I first thought about starting a website for doctors in private practice, I planned to develop a team of medical practice experts to teach all of the doctor members useful facts and impart general business knowledge that most doctors don’t get taught in their long education.

Medical practice experts will still be part of this goal, and many of the upcoming podcasts will feature these experts. But I realize that there are many fine brick and mortar and internet resources for medical practice management information available to physicians. 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.

See One, Do One, Teach One

All physicians know the adage “See one, do one, teach one” from medical school and residency training. Typically it’s used in reference to some procedure we need to master, like starting an arterial line or putting in a chest tube, etc. While it over simplifies the learning process we all go through, because we usually watch a procedure more than one time before trying it ourselves, it makes the point that you need to do something before you can teach it. Politicians in Washington may not understand the concept, since they seem intent on telling business folks how to run their businesses despite the fact that most of them have never run, much less started, a business. But all doctors “get it”. Read more