A cramped, solo slice of heaven

This tiny, bare bones ‘micropractice’ is FP Gordon Moore’s idea of paradise. No secretary, no nurse — and no hassles

By Peter Woodford April 30, 2007 National Review of Medicine

“In many ways this is a Norman Rockwell practice with a 21st century technological backbone,” muses solo FP Dr Gordon Moore of his Ideal Micropractice vision, speaking to NRM from his tiny Rochester, NY, office. “I’ve had some docs who’ve been practising for 35 years who’ve said ‘you haven’t invented anything here’ and they’re right — I’m just using technology to make it possible today.”

Exactly what Dr Moore, who’s also a researcher at the Institute for Healthcare Improvement (IHI), is doing will strike many doctors — particularly Canadian MDs — as completely nuts.

Imagine answering your own office phone and giving out your email address and cell number to patients. Throw in some same-day booking and 30 minute patient visits and you start to get an idea of how things work in Dr Moore’s office. But there’s a method to the madness — in fact it was his IHI research that led him to hang out his micropractice shingle. Well, that, and the pressure to see more than 30 patients a day at his former group practice in a big HMO.

It’s been six years since he said goodbye to group practice, and he admits there are some adjustments to make. A doctor who opts to follow the micropractice model — no secretary, no support staff, just the doctor and his computer — can expect to make less money than by joining a traditional practice. The dollar difference largely depends on how good one is at keeping down costs but as a ballpark estimate, expect to earn 30% less than you would in a group.

So why would anyone want to take a pay cut? For pretty good reason, says Dr Moore: micropractice docs get to spend more time with patients, be their own boss, and generally be under less stress. “The joy-of-work quotient for us in our practices is huge,” beams Dr Moore.

For Dr Moore, if a micropractice is to work it requires four things: great access, enhanced patient interaction, reliable clinical care and practice vitality in the form of low overhead. He’s a big proponent of open-access scheduling — also called same-day booking — as a solution for access problems. “We think open access is a delight for patients and less work burden for a practice because we don’t have to negotiate a delay — you’ll be telling them “Sure, come on in today,” he says.

But giving patients his cell phone number and email — meaning he’s essentially always on call — is a recipe for disaster, right? “No, the inappropriate call is a very, very rare event. People are very respectful. It’s been a delight compared to working in a call group, which I found overwhelming,” he says.


Continue article: http://www.nationalreviewofmedicine.com


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