A small but increasing number of physicians are trying to use technology and curb overhead costs to make family practices more manageable and profitable, the Wall Street Journal reports.
The number of primary care physicians has dropped by half in the past 10 years, according to a series of surveys by the American Academy of Family Physicians. However, the trend of converting to “micropractices” could help counter the decline in primary care medicine, according to the Journal.
For example, Dr. Gordon Moore in early 2001 opened a solo practice and by keeping overhead costs low, he was able to see fewer patients, provide them with better care and still earn a decent income. He previously worked in a large hospital-owned medical practice and grew frustrated by the pressure to see more patients, which he said resulted in errors and prevented him from providing the best care possible.
Moore pays $250 per month for software that combines electronic health records, patient scheduling and electronic billing. Moore also purchased off-the-shelf disease management software, called DocSite, to track patients’ cholesterol, blood pressure and blood sugar levels. In addition, Moore asks his patients once or twice a year to complete an online survey, called “How’s Your Health.” The survey, developed by John Wasson of Dartmouth Medical School, asks patients a series of multiple choice questions about their symptoms, medications and habits. The survey evaluates patients’ answers and provides a one-page snapshot of their health.
Moore estimates that his overhead costs account for 35% of his revenue, while overhead costs for most small primary care group practices make up about 60% of their revenue, according to the Medical Group Management Association. An online survey found that 70% of Moore’s patients received the care they wanted and at the time they wanted it, compared with a national satisfaction rate, based on the same survey, of about 30%.
Some physicians considering a solo practice are concerned about:
- Leaving the financial security of a larger physician organization;
- Setting up the technology and organizing a practice; and
- Difficulty signing up new patients.
Dr. Gary Seto, who three years ago left Kaiser Permanente and started a solo practice in South Pasadena, Calif., said he scaled back his practice to part time after losing money for two years. On his blog, SoloDoc, he wrote, “That’s the tradeoff. But it’s much more enjoyable to me and my patients.” Seto received a two-year, $850,000 grant from the Physicians’ Foundation for Health System Excellence in Boston to promote his practice model (Naik, Wall Street Journal, 2/23).