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Learning to Adopt a Slow Medicine Work Flow


As things start to pick up at her new practice, this doctor shares some of the challenges of her new practice model.

Things are picking up with my new practice. For the most part, patients are finding me through word of mouth and I'm getting busier. Now the challenge is keeping up.

My patients are very complex and the testing I send can take up to sixweeks to come back. I can create a plan of action only after the test results are back. It's the slow nature of what I do that is creating difficulties for me because it is an entirely new work flow. And so far, I haven't found the best solution. This week I'm trying sticky notes on a bulletin board, one for each patient. I'll let you know how that goes.

My office has more furniture, but still not enough. We need to move chairs around from waiting room to exam room and stools are used as writing desks for our computers. But the patients don't seem to mind.

The most pleasant surprise is how enjoyable it has been dealing with patients in an out-of-network model. They are mostly very cooperative with getting records to me before the appointments and promptly get the recommended lab testing completed. And when their appointments need to be changed, they don't give us hard time about it. Perhaps this is just beginner's luck on my part, but so far, the patients have been wonderful folks to work with.

However, I think a big part of why my new patient base is so easy going is directly due to communication. I do all my own call backs rather than delegating to a nurse. I let them know that I answer portal messages quickly, except there will be some days that I don't log into the EHR. They know they can send text messages through my telephone system and many of them have my cell phone number. They also know that it is only me here and so far, I have had no one abuse having direct access to me.

My front-desk receptionist lets patients know what the office cost will be and reminds them to send their records before their appointment so everyone's time is used efficiently. We are also very flexible in our scheduling ability. And of course, for follow up patients, they really like telemedicine appointments I offer after hours and on weekends.

One of the best benefits is what I wear to work. People don't come to see me because I'm a fashion icon! I'm not out to impress anyone with clothes. I'm happiest in blue jeans and tennis shoes, so that's what I wear.

In total, I'm glad that I've gone to "out-of-network" care. I have the luxury of more time getting to know my patients. And even though I've only been open in my solo practice for a few months, I do have some things I would have done differently:

1. Just spend the money and buy the furniture and decoration needed to make the office look complete from day one.

2. Be more proactive with marketing and networking.

3. Get a better copier (we opted for a very basic model), especially one that does color.

4. Buy shelving. Lots more shelving! You can never have enough storage!

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