Skip to main content

Can Private Practice Survive?

Image
By


Just read another article forecasting the demise of private practice, which is the model I practice in.  We certainly feel the squeeze here in Cleveland, where our small gastroenterology (GI) practice is suffering from some breathlessness as surrounding health care institutions suck up oxygen in the community.

Now, being deprived of oxygen isn’t necessarily fatal.  Many patients suffer from diseases that result in low oxygen levels in their blood.  Folks who live at high altitudes don’t have the same concentration of oxygen available as do those who reside at sea level.  Yet, they live active lives.

How do these folks survive?  Do they have lessons for my GI practice?

Take a Deep Breath...

Here are some options that help individuals with low oxygen levels breathe easier.
  • Receive supplemental oxygen using an oxygen tank.  No analogous solution for my medical practice here.  For us, the ‘oxygen level’ can’t be artificially increased.
  • Reduce activity level to minimize oxygen requirement.  This is why folks with respiratory conditions tend to remain sedentary so they can function at a lower oxygen level.  Not sure if there’s a lesson here for our practice.  Do we move more slowly in the office?  Do we see fewer patients?  If we doctors used oxygen tanks, would this inject more vitality into the practice?
  • Attack the root cause of the oxygen assault.  If the cause of a patient’s low oxygen is pneumonia, then prescribe the right antibiotic to reverse the injury.  If the doctors in our practice attacked the proximate cause of our oxygen deprivation, we could go to jail. 
  • Train at a high altitude locale for athletic competition in the lowlands.  Marathoners seek out high altitude training courses to build endurance in preparation for the big race down below.  Perhaps, we should move our practice to high altitude Colorado for a year.  After doing colonoscopies there for a year, imagine the increase in our performance when we returned to Cleveland?  I will place this on the agenda of our upcoming practice meeting. 

Great choices for us.  Breathe less, do less or move.


Labels:

Comments

  1. PedlungAugust 27, 2014 at 12:04 PM

    Interesting analogy Dr. GI specialist. Particularly this was to me, since I practice Pulmonology and I am in the process of opening a practice in a hilly area. Hopefully this will give me endurance increasing my Hb and cope with hypoxia that you now experience. If you move to high altitude of Colorado, the development of your compensatory polycythemia will make you tolerant to the hypoxia . The later which will help you transiently. when returning to Cleveland. However you may experience same Oxygen deprivation again unless if you keep steady running during your practice :) ...

    ReplyDelete

Post a Comment

Popular posts from this blog

When Should Doctors Retire?

By
I am asked with some regularity whether I am aiming to retire in the near term.  Years ago, I never received such inquiries.  Why now?   Might it be because my coiffure and goatee – although finely-manicured – has long entered the gray area?  Could it be because many other even younger physicians have given up their stethoscopes for lives of leisure? (Hopefully, my inquiring patients are not suspecting me of professional performance lapses!) Interestingly, a nurse in my office recently approached me and asked me sotto voce that she heard I was retiring.    “Interesting,” I remarked.   Since I was unaware of this retirement news, I asked her when would be my last day at work.   I have no idea where this erroneous rumor originated from.   I requested that my nurse-friend contact her flawed intel source and set him or her straight.   Retirement might seem tempting to me as I have so many other interests.   Indeed, reading and ...
69 comments
Read more

The VIP Syndrome Threatens Doctors' Health

By
Over the years, I have treated various medical professionals from physicians to nurses to veterinarians to optometrists and to occasional medical residents in training. Are these folks different from other patients?  Are there specific challenges treating folks who have a deep knowledge of the medical profession?   Are their unique risks to be wary of when the patient is a medical professional? First, it’s still a running joke in the profession that if a medical student develops an ordinary symptom, then he worries that he has a horrible disease.  This is because the student’s experience in the hospital and the required reading are predominantly devoted to serious illnesses.  So, if the student develops some constipation, for example, he may fear that he has a bowel blockage, similar to one of his patients on the ward.. More experienced medical professionals may also bring above average anxiety to the office visit.  Physicians, after all, are members of...
8 comments
Read more

Inpatient vs Outpatient Care;: Can Doctors Do Both?

By
Five years ago, I left hospital wards and emergency rooms behind and entered a new & improved medical practice model, at least for me.  Since then, I only see patients for office consultations and procedures.  Office medicine is a very different trade than hospital practice each having very distinct skill sets.  If I were to return to the hospital now to see patients, it would be uncomfortable for me (and them) having not used these skills for years.  Similarly, hospital-based doctors might find transitioning to an office practice to be clumsy and uncomfortable. While it might seem that a gastroenterologist or any medical specialist should be able to see patients in any location, this is not the case for most of us.   Hospital medical issues are quite different from office medical complaints.   Physicians, as in so many other occupations, need repetition in order to maintain high competency levels.   There’s a reason, for example, that airline pi...
7 comments
Read more