Home Forums Discussions Problems DEEP THOUGHHTS by Walter Handy

Since this has sort of segued into a thread about how we run our practices, I'll keep going.

Walter, we bought our office space many years ago, convinced it would be a good investment..Then, we were rudely reminded of the second half of the basic definition of fair market value, "what a buyer is willing to pay..." A medical office building can suddenly become a white elephant, since it may only be suited to a medical practice. The hospital bought our building, and now we rent. We have 1 year renewable leases year after year. I can walk out the door any time with a maximum of less than 1 year rent at risk. Freedom is a wonderful feeling. I once calculated that over the 20+ years we owned the office, our group paid out over $1,000,000 more for office space than if we had rented. We got back about $200,000 when the hospital bought it.

Wayne, we use UpDox to contact each patient with their test results. We actually do use the dreaded templates here, saying things like "Your lab is basically normal..." and adding that if there are further questions they should feel free to make an appointment. We also offer to answer brief questions by e-mail for a fee, warned insurance won't pay, and have almost no takers. Of course, if it is abnormal, we contact the patient to make an appointment to discuss. UpDox lets us document what we told the patient as well. It averages about 2 minutes per patient to import labs, notify patient, etc. I have 6-7 labs a day, and it gets done in the morning while I'm sipping coffee. Some patients don't want to use the portal, and we graciously offer an appointment. I have been known to say "The folks you voted into office forced us to to go electronic, and if we suffer, you suffer." Using UpDox slams the door on the discussion that morphs into a free office visit by phone.

Now it's time to poke the hornet's nest again.

We fire patients with minimal provocation. If someone is nasty to my staff, misses multiple appointments, exhibits drug seeking behavior, etc., they are history. They get 30 days of emergency access, then bye. I don't usually do this for simple non-compliance; I take those folks as a challenge to try to figure out how to get them involved in their own care. This topic has come up before, and always ignites a storm. Let's just say that we have almost no patients whom we dread seeing. Also, we practice in an area where primary care is hard to get, so it is sort of a seller's market, and we've been in practice for a long time. That certainly helps in the confidence arena, and a patient leaving now is merely a curiosity (mixed with the smug knowledge that they were pretty spoiled with us, and "brand X" is not going to treat them so well.)

Our community is constantly trying to recruit new physicians, offers all kind of incentives, and is a really magical place to live if your tastes run to the mildly exotic. I have never heard of anyone with a lick of sense who did not prosper. However, it is really tough to find docs who will practice here, and once again, reading posts by folks who are having a tough time financially, I wonder why. We should be beating you off with a stick!!