ACOs and My Practice: Is ACO Just Another Confounding Obstacle?

April 18, 2011
Melissa Young, MD

Unless I can find a way to learn about ACOs through osmosis while I sleep, I’ll hold off on weighing in.

I was asked a week ago if I was interested in writing about my take on the proposed Accountable Care Organization rule and what I thought the impact might be on a small practice like mine. I decided that I was not in a position to really make that kind of assessment, because I don’t know enough about it, and quite honestly, I don’t have the time to read about it right now. 

“Why not?” you ask? I’m just too darned busy. Forget the fact that I have two young children, each with two activities they have to be shuttled to and from. I have stuff to do.

Let’s start with the daily nitty-gritty. I decided that it was not cost-effective to have an office manager, therefore, I AM the office manager. I make sure the office is clean and presentable; that the patient education material and the People magazines are neatly placed in the waiting room every morning. I make sure the back up system for the EMR is working. I troubleshoot the computers/network/EMR to the best of my ability as needed. Oh sure, I delegate. My MA is in charge of making sure we have enough supplies, and I have her keep an inventory. But I still check periodically, ’cause I just can’t afford to not have what I need when I need it. I even make sure there’s enough toilet paper in the bathroom. Then, there’s keeping track of staff members’ hours for payroll. And then, of course, my personal favorite: making sure the bills are paid.

I still have to figure out how to get my EMR incentive. And then there’s ICD-10 to look forward to. And I have to make sure I get enough CMEs to keep my license.

Oh, and somewhere in there, I need to squeeze in a little thing known as patient care. You know, actually talking to and examining patients, counseling, educating, etc. I have hospital rounds. And then there’s the paperwork involved in that - the prior auths, the pre-approvals (what’s the difference anyway?), the appeals. And the phone calls. I’ll swear, I ask every patient while they are in the office two things: 1) Do you need any prescriptions, and 2) Do you have any questions? And invariably, I will get the call the next day from two or three patients for prescriptions, or for instructions, or something.

So, right now, unless I can find a way to learn about ACOs through osmosis while I sleep, you’re just going to have to wait for my opinion.

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