Well, I'm not too self-absorbed :-D,
but since you asked, Bert....
When I started out solo in 2003 I started out on a shoestring in a tiny office with one nurse. Not long after, the nurse moved on to better, more lucrative things and I continued running my office alone.
Not long after that, I saw an article in Medical Economics called "1 doctor, 0 staff" which profiled the practice of Jim Ochi, MD, an ENT in San-something California. I spoke with doctor Ochi at length and we shared our ideas (mostly his ideas) about running a practice with NO STAFF whatsoever.
He introduced me to Paperport which he uses for keeping his charts. DNS was used for transcription. He uses Microsoft online tools for patient self-scheduling, and answers his phone messages. In addition, he has a website.
Some of these ideas I incorporated into my practice, but mainly the use of paperport, along with the greater self-confidence of knowing that there are other physicians out there--a few besides Dr. Ochi in fact--who practice in this (absurd by conventional standards) practice model. I also use a wireless camera to keep an eye on the waiting area while I'm in the exam room--that's my own thing. ("No comments about how I should give myself 100% to the patient" hahahha--am I quoting anyone?)
I handle all the charting and communications/phone by myself. The only thing I outsource is the billing. Practicing in this way creates a miniscule overhead, allowing me to schedule few patients per day, with longer visits per patient and still keep a nice lifestyle going.
I am happy for others who find the traditional practice format meets their needs, but for me, this is the only way that makes me happy.
