Putting Yourself Out There
Less than a year ago, however, Schneider opened a direct primary-care practice Raleigh and is working on a fellowship in integrative medicine, which she expects will help attract patients.
"You do replace it with another kind of stress in that you need to recruit patients, but this is much better," she says. "You have to put yourself ''out there,'' but that's my personality anyway."
Elise Fulsang, MD, also recently started up a DPC practice in Waikoloa, Hawaii after practicing as a hospitalist.
"I was coming up on 57 and the realization comes upon you that the 12-hour shifts aren't something that can be sustained long term," Fulsang says. While she now enjoys spending up to two hours with patients, she worries about whether she'll be able to build up enough of a patient panel to make a living. To set up her new practice, she has cut into her personal emergency fund. She also has the unique Hawaiian economy to contend with, including high prices for office furnishings and difficulty getting discounted labs and drugs for patients, she says.
"I'm no longer burned out, but I am scared," she says. To get the word out about her practice, she's given talks to a local rotary club and has made connections with vacation rental landlords about providing care for short-term guests.
For Lisa Larkin, MD, starting a DPC practice near her formerly long-time practice in Cincinnati, Ohio helped her get up and running quickly. After the first seven months, her practice was up to just under 800 patients in February for herself and two employed providers, a physician and a nurse practitioner. She's aiming to close the practice at about 1,200 patients.
"My two providers hands down will tell you the stress level is vastly better now," she says. Larkin originally sold her practice to an academic center, then continued working there until she tired of the bureaucracy.
"Of course, [her employees] have the security and I have the debt. But if you take away the financial pressure, the truth is professionals are passionate about what they do and at the end of my day I feel like I'm doing a better job than I was before. Instead of seeing 26 patients a day, I'm seeing about 16. I would stop practicing altogether before I'd go back to doing it the old way."
Clint Flanagan, MD, founder and CEO of Nextera Healthcare, a DPC practice with several locations, still runs a Colorado fee-for-service practice in addition to Nextera. He says his worst days in the DPC practice are better than his best days in fee-for-service family medicine when it comes to stress and overall satisfaction.
"You enjoy relationships with your patients and you are not wasting your time, and wasting time leads to more burnout than anything," he says. "It puts the physician back in charge."