MEDICINE OUTSIDE THE BOX
( continued from page 15 ) misunderstanding by colleagues and patients alike of why each prodigal doctor chooses to break away will follow you . Knowing who you are as a person and physician will help the rocky transition .
I left traditional practice but that doesn ’ t mean I stopped being the doctor that refused to leave the office until the work was done , or stopped being the doctor who would take calls during dinner time or at my kids ’ games . I just had more time during the day to complete my work tasks so I could focus on what was most important to me . I ’ d achieved real work-life balance .
So what tips would I give to those that are considering the transition to a retainer-based practice ?
1 . Believe in what you are doing .
Unfortunately retainer-based medicine has had a stigma attached to it , that as a doctor , one is selling out for a better lifestyle and betraying the Hippocratic Oath . I am not going to argue this point , but I will say that if you feel this in any way , then concierge medicine isn ’ t for you . You won ’ t do well because your heart won ’ t be in it . It is vitally important that you love what you do and believe in it . If you don ’ t , your patients will realize it and will go elsewhere ( negating the whole “ retention ” aspect that makes this type of practice financially viable ).
2 . Answer your phone .
Patients are paying you for your time and your access . If you are not available , what are they really getting out of your practice ?
3 . Hire good staff .
Everyone has heard it before . Maybe even with your current patients . “ I love Dr . X but I just can ’ t stand his / her staff .” Trust me . The patients come for the doctor and access but they STAY for the staff .
4 . Be kind and compassionate .
While most doctors believe themselves to be the second coming of Marcus Welby , the current system they are in does not foster this . They are constantly harried , moving at a breakneck speed , trying to remember to send in the proper orders or prescriptions . When under this intense pressure , they may forget to listen to the patient and remember that the person in front of them is scared , nervous and most likely worried that they have some horrible disease . Calm them , and when there really is a problem , reassure them that you will be there with them through it all .
5 . Listen .
It seems like Doctoring 101 but again , I can ’ t say it enough . In the immortal words of Dr . James J . Hines , “ If you listen to the patient long enough , they will tell you what is wrong with them .” In a retainer-based practice , you now have the time . Don ’ t squander it .
6 . Be the patient ’ s advocate .
It may sound simple and I am sure I will ruffle a few feathers as most physicians do feel they are the patient ’ s advocate . For the most part that is true . But most doctors are their advocate for the allotted eight minutes they see them and then it is out of sight , out of mind until their next eight minutes in four months . I sound like a broken record , but you have the time now to do a deep dive into your patient ’ s health . Spend time on the family history , update the immunization list and finally get around to the screening tests . Talk about alcohol use or overuse . Broach the topic of domestic abuse . You have the time . USE IT . Being the patient ’ s advocate also means protecting them from themselves . Information is plentiful in this day and age and there isn ’ t a day that goes by that a patient doesn ’ t reference the desire for a certain test or X-ray . It is our job to order tests because it will make a difference in a patient ’ s care , not to satisfy the curiosity of the doctor or patient . I order fewer tests now than when I was in a traditional practice because I now have time to discuss what I would or would not do with the test results . By doing this , the patient feels a part of the decision-making process and ultimately a participant in their health care process .
Retainer-based practice is not for everyone . I realize that and would not say that it is a solution to the health care problems that plague our country . This is just my story , my thoughts , my observations . I hope that this gives some insight into what I have found to be the most impactful change to my professional life and easily the most satisfying .
Dr . McClellan is an internal medicine physician with OneMD-St . Matthews .
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