Home Forums Discussions Problems DEEP THOUGHHTS by Walter Handy

Walter, it hasn't been easy for me to teach Alice some of these things. Still working on it as we go, but we have made progress.

I remember when she first asked me to help market her practice. She'd been here 4 years, but had hardly any patients. And then still wouldn't listen to my advice (after she asked me for it). But her file cabinet had only 65 charts.

One issue was she felt she needed to personally call each patient and discuss on the phone their lab results. It was her responsibility as their doctor.

Now, this is a laudable sentiment. But...completely impracticle. We had some "heated discussions" about this. Then one day, I walked into the office. She was sitting their looking lost. There was a stack of 45 charts on her desk (This was after I had successfully begun to build up her patient volume). She was trying to call them. So I interrupted her to begin this conversation again. This time she looked at me, then looked at the stack. Then grudingly said "maybe you're right. yes. I just don't have the time to do this. And the insurance companies wont' pay for a telephone consult." Only after this was I able to make headway on these issues.

If your wife is like my sister (sounds like she is), and has this type of feeling of duty to her patients (which she probably does) then I do understand that you can't just suddenly get her to agree to alot to these things. Its a continuum. And some things she will eventually feel comfortable about, and some not. But it sounds like she is far past the point Alice was. She will physically not be able to continue unless she changes some things...but its obvious that you know that already. Often, the last person to notice that someone is really truly burning (burnt) out is the one who IS burning out. It happened to me when I was a consulting manager.

I know it bothers Alice when patients leave for another doctor. Frankly, it bothers me too. But here in NYC people switch all the time at the drop of a hat, so once you begin to realize that its easier to accept. Having other patients that have been with you for years helps too.

One thing that will happen as you start implementing stricter policies which allow you to be profitable and sane is that the patients that were happy because you were so lenient will leave to look for someone else who lets them get away with these things. You (she) has to be able to accept that, and it will help when she notices that other patients don't seem to mind, or will comment that their previous doctor did the same thing. So you really can only change one or two things at a time to limit the sudden loss of income and to not run into a wall of self-doubt.