tag:blogger.com,1999:blog-9181810725696409953.post7073133913533760535..comments2024-03-17T04:20:11.083-04:00Comments on The Population Health Blog: More on the (Non)Death of Small Independent Physician-Owned Primary Care PracticesJaan Sidorovhttp://www.blogger.com/profile/05072456803925863874noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-9181810725696409953.post-61398726323441078412010-07-10T10:31:37.403-04:002010-07-10T10:31:37.403-04:00From a solo FP with 25 years in, and solo independ...From a solo FP with 25 years in, and solo independent for 6 years:<br /><br />Thank you so much for pointing out this model of independence IS viable and rational.<br /><br />It is telling that:<br /><br />1) Mayo clinic in Arizona no longer takes Medicare and INSISTS on "upfront" $1500 payment.<br /><br />2) House of reps voted 417:1 to confirm the 2.2% increase (really stable) reimbursement for Medicare services after 3 weeks of NONPAYMENT of Medicare claims in June lead to a statement through the AMA, AAFP that 30% OF PRIMARY CARE MDS WERE NO LONGER GOING TO TAKE ANY NEW MEDICARE PATIENTS.<br /><br />3) There is a movement offoot for "concierge" practices to be more of a "subscription" type fee based practice, where an "enrollment fee" of about $50 per month covers overhead for the doc, and insurance is still used. <br /><br />4) A recent article in a leading journal states unequivocally that about $250 is spent per year for outpt primary care doctor fees, and if $600 (about $50/month!) was spent up front, then these quality initiatives would be actually doable!<br /><br />With this model I could do quite well; even if I never go monthly fee, I'm getting there bit by bit with secure email, EMR (x 10+ years), ePrescribing, and 10-15 pts per day in my solo.<br /><br />Still moonlighting though 1 day a week (if I was at 50 pts/week I wouldn't have to do that either...).<br /><br />Dr Matt Levin<br />Family Medicine, Board certified<br />Pittsburgh, PA<br />dr-levin@comcast.netAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-87745957406519228712010-07-08T13:41:39.297-04:002010-07-08T13:41:39.297-04:00As a "service industry" it makes sense t...As a "service industry" it makes sense that small, lean staffed physician offices can do well. It seems to me the key success factors will be:<br />1) excellent customer service<br />2) ease of access (i.e. same day appt)<br />3) excellent info systems with a minimum of paper and paper communication (i.e. snail mail and fax)<br />4) tight integration with other systems (i.e. home health, hospital info systems)<br />5) good cross-coverage arrangements<br />6) ?lower physician earnings expectations<br /><br />I could see an office staffed by an RN and an MD with an "automated" check in system, the physician and RN sharing patient care duties and check in duties, EMR,on-line scheduling, rapid turnaround on phone calls etcPhil 314https://www.blogger.com/profile/04133300763922742206noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-71680999574563407812010-07-07T08:30:33.654-04:002010-07-07T08:30:33.654-04:00So true, Dr. Syn! Ten years from now, all the pun...So true, Dr. Syn! Ten years from now, all the pundits will be able to take credit for their predictions, because it'll all come true. Practices will splinter into myriad business models. That being said, there's a good possibility that the large publically financed "take a number and wait" clinics could end up at the bottom of the service/profitability heap.Jaan Sidorovhttps://www.blogger.com/profile/05072456803925863874noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-60057639892328251542010-07-07T00:45:49.971-04:002010-07-07T00:45:49.971-04:00The DMCB has good insight on the potential for sma...The DMCB has good insight on the potential for small, elite highly motivated kiosk docs to pop up in malls all over America... or street corners, or closets.<br /><br />Seriously, to actually survive, they have to initiate direct primary care practice, such as Qliance in Seattle or Health Access Rhode Island, then attract or hold patients who value a personal, relationship focused physician. Then the patient must believe that paying their own money for primary care is worth it.<br /><br />You are accurate in comments to the effect that few will seek to transform into or continue to be the small, profitable family practices, but many will. In ten years when the smoke clears, we'll know what we should have done. Peace.Dr Synonymousnoreply@blogger.com