The Medical Practice Playbook
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did Newborn Classes in the office and hospital, spoke with PTA groups, women’ s clubs and church groups – whoever would listen.
2. Be creative and embrace change. This is the only certainty in medicine. Things are going to change. Don’ t shirk from it but rather charge into it. Try different things and then move on if it doesn’ t work. Be willing to be different. We constantly tinkered with our schedule, phone triage and well-visit routines. We experimented with a variety of evening parenting classes, tried group well visits or obesity programs, enrolled in clinical trials, recruited ancillary services such as dietetics, speech therapy, child psychology to improve patient access. We were lucky to have two of the very first nurse practitioners in town, Sue Buehner and Jinny Hunt, who were instrumental in supporting our nursing mothers. We even helped build a consortium of likeminded independent pediatric practices. When any of those endeavors no longer fit for our practice, we moved on. Be humble enough to know that your practice has never arrived but is always on to the next adventure.
3. Love your work. Don’ t do this if you expect a 9-5 job and want to go home and forget about it. It is hard. Your patients are a priority and sometimes you must be willing to work longer to provide premier care. People notice if you are willing to go the extra mile or not, if you approach them as valued clients or not, if you are willing to change your practice as circumstances demand or not.
4. Have a philosophy of practice and stick to it. We were all Board certified and practiced under the guidelines of the American Academy of Pediatrics. We used their practice guidelines, and we let our patients know this. We did not alter the vaccine schedule. Steve and I established from the start that we were going to try and see every sick or injured patient on the day they called. This made for quite variable seasonal schedules but was highly valued by patients. Few complained about getting appointments late in the day or evening when they understood that we would always see them. We also established a philosophy that all physicians would work equal schedules and draw equal salaries. This originated from the need to see everyone on a same day basis, but in the end, we also felt that it builds camaraderie amongst providers and decreases any sense of competition or that someone is taking advantage of others. It also means each of us feels a sense of responsibility to our partners. This is not for everyone, but we would encourage you to consider the advantages. important. It’ s easier said than done, but every physician knows that they are only as good as the people around them. You are likely to have lots of turnover since medical staff are often young and mobile. However, when you find someone good, make sure they cannot leave you. Pay them well in salary, benefits, retirement. Focus especially on a few keystone positions like administrator, nurse manager and providers. It is cheaper to pay valuable staff a bit more than have constant turnover. Praise them, make sure they know that they are appreciated. A practice manager is often the most important person on staff, but they can also do little things to promote team building and identity. Have office meetings, holiday events, special meals or potlucks to build a sense of identity. Remember that your staff is the face of your practice and spend more time interacting with your patients than you do. East Louisville Pediatrics is lucky to have great physicians who continue to adapt and evolve and reinvent the practice for the future. It is in good hands.
6. Get involved. Join GLMS or your local specialty society, serve on hospital committees. Doing so allows you to interact with your peers, exchange ideas, keep abreast of insurance changes and new laws, regulations, CME requirements. It also lets you have some voice in decision making at a time that trust in medicine is being challenged.
Enjoy the journey. If you build an independent primary care practice it will be your baby, your adopted child. You will want to see it grow and thrive and be willing to do anything for its health. You will be rewarded long term, just like having your own children. As with a newborn, you will miss some sleep, feel exhausted and grow frustrated at times. But it is its own reward in the end. It should be the hardest job you will ever love.
Dr. Jones and Dr. Church are retired pediatricians from East Louisville Pediatrics.
5. Hire and nurture good people. This might well be the most
8 LOUISVILLE MEDICINE