‘Micro Practices’ New Prescription for Personalized Health Care

June 4, 2009  
Filed under Health & Wellness

By Joy Perrino Choquette

When was the last time you called your doctor’s office and the doctor himself answered? Can you remember when you last made an after-hours appointment and your doctor met you at the clinic…on a Saturday evening?

Patients of solo medical practices, also known as micro practices, experience these types of “luxuries” all the time. In an age where doctors see more and more patients, and patient visits are becoming shorter and shorter, micro practices are quickly gaining in popularity.

Micro practices are a return to the model used by old-fashioned country doctors. Those physicians, who treated everyone from babies to seniors, used to travel to people’s homes when they were ill, a convenience that’s been all but forgotten. Though today’s solo practitioners don’t routinely do home visits for the most part, they do take care of just about everything else.

Physicians who have a micro or solo practice often take on multiple roles including reception and nursing care. Many wear other hats as well, such as bookkeeper, records manager, and emergency on-call doctor, among other things. Typically, physicians who practice solo see far fewer patients than group practitioners. They are also able to spend a great deal more time with each patient. How are they able to do this? Overhead is dramatically lower for solo physicians. The trade off is the fact that they must wear so many hats.

According to Roger Giroux M.D., of Brookside Family Health Center in Hinesburg, the benefits far outweigh the drawbacks. “I’m kind of a do-it-yourself type and I like keeping it small,” said Giroux. “I’m not big into paying a lot of staff for things I can do myself like drawing blood and giving shots.”

Hiring a nurse would mean he would have to see more patients, explains Giroux, and that would mean extra overhead. Giroux says it’s worth it to him to keep his costs as low as possible, allowing him more time and energy to focus on his patients.

Having lower overhead and seeing fewer patients allows a physician to have a more flexible schedule. Avery Wood, M.D., of North Bennington, says that that is a great benefit to her. “I’m very much in control of my finances and my schedule,” said Wood. “There’s a simplicity to that, and I like the flexibility.”

Wood, who previously worked in a group practice, says she enjoys the fact that her patients can call and speak to her directly. “My patients always see me except when I’m out of town. And when they call, they talk to me.”

Micro medical practices, which are common in Europe, are sprouting up throughout the United States. Benefits to both the physicians and the patients are numerous. In most group practices, it’s common to see various physicians instead of a patient consistently seeing his or her own doctor. In fact, depending on a doctor’s working and on-call schedule, it might be months before a regular patient is seen by his own doctor. “I think my patients deserve to see me, and not a stranger,” said Giroux.

A patient should not have to jump through hoops to see his doctor, he says, and the fact that so many group practices are run this way is often frustrating to patients. “When they (patients) call here, about half the time I pick up myself,” said Giroux, who runs the office with the help of his wife. “The whole thing happens very efficiently . . . the patient gets better service that way.”

In addition to being able to more easily access his or her physician by telephone or in person, there are other benefits a patient visiting a micro or solo practice might experience. More in depth attention to the patient is an extremely important benefit, says Giroux. He says that there are often a lot of questions doctors should be asking that they specifically don’t because it will throw their entire schedule off a half hour or more. “I can schedule my book as light or as full as I want it to be, not dictated by the dollar, but by how busy I want to be,” he says.

Wood, who also feels that easy access to a physician is one of the greatest benefits, has added a new way of communicating with her patients to make this process even easier. “I’ve been able to start some new things like communicating with patients by E-mail,” she said. “It works out really nicely.”

But if there are so many benefits to patients and physicians alike, why aren’t more doctors getting on board with solo practices? Money is one of the greatest challenges. Giroux explains that family doctors already get paid less than specialists. More and more young doctors are choosing to specialize and there is little incentive to enter the medical field as a family doctor. “Until the system changes where they actually pay the primary care doctors what they should be paid, I don’t think it will be popular,” says Giroux.

According to Wood, the importance of electronic medical records is essential to micro practices. And though the cost can be high for such a system, the benefits are well worth it. Being a one woman show, Wood says it would be very difficult for her to stay on top of all the information without the electronic system. The cost of such a system may be one more deterrent for physicians who are interested in exploring the idea of a solo practice.

Still, the number of solo practitioners does seem to be growing, though slowly. And for patients, the benefits seem to far outweigh the negatives. “I’ve been getting a good number of people every week who want to come and meet me, and I’m impressed by that,” says Giroux.

 

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