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Click here to view an article about a talk I gave at the 2009 American Academy of Family Physician Scientific Assembly: Patient-Physician Alliance Can Improve Asthma Care. |
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****************************************************************************** Irvine World News Tuesday, November 13, 2007
Irvine physician shares about going private and the "Ideal Medical Practice" movement.
Sharon McCoy George left group practice in pursuit of personalized visits and more time with patients.
By CATHY TRAN
STAFF WRITER
About two dozen students, doctors and residents mingled in Sharon McCoy George's home Friday for minestrone soup and a chat about personalizing doctor visits and spending more time with patients. The UC Irvine associate professor and family physician invited Gordon Moore to speak about his switch from group to private work the Ideal Medical Practice movement he started. Here is an interview with George.
Can you tell me more about the movement?
Dr. (Gordon) Moore started the Ideal Medical Practice movement in 2001. His idea was that to improve patient care, primary care doctors needed to have more time to form deeper relationships with their patients. He did this by lowering the overhead in his practice with no staff and just one room instead of a big office building. He did all the referrals, prescriptions and communication through his laptop. A number of doctors have followed him since then.
You've switched from group to private practice for almost a year. How'd you plan that?
My husband and I were in Italy for sabbatical so it was during that year that I did a lot of e-mailing back and forth with doctors on the (Ideal Medical Practice) listserv to plan my practice. That's a great way to learn what it's like and what challenges people are having. One of the most important things when you are starting out is to keep overhead low. I practice out of my home (rather than rent an office). High overhead traps many people so they have to see more patients than they can comfortably take care of and then you kind of create a cycle of poor care.
How has your practice as a physician changed since the switch? I have a lot more control over how the patients are treated. When I want to make a change to a procedure, I don't have to go through committee meetings or wait through approval. In group practice, to put a flow sheet in the chart to keep track of diabetes, I would have to wait for all those forms to be approved through committees so it was difficult to make changes quickly. I like to give people patient education material to read and I can gather information that I know is reliable and go ahead and give it out to patients now.
What has been the most difficult part of having a private practice?
One challenge has been learning the business aspects because before I didn't really have any responsibilities for managing the orders or the business license and all those different things. There is no guaranteed salary so it definitely was a cut in income for the first year. It's picking up now.
What has been most rewarding part of the switch?
The most rewarding part is the relationship I have with my patients and how I feel by making myself available to them whenever they need to call me. Some people want to stay at home when they're sick instead of going to the hospital. Some people just need some information and they're often able to manage things on their own. It's nice to know people well enough to personalize my practice to (match the) relationship they want with their doctors.
Do you think it will be easier or harder for doctors to personalize practices with the current trends in health care?
I think that employers and insurance companies are starting to realize the benefit of good primary care and prevention. I'm actually hopeful that soon it's going to be a lot easier to practice this way. I know Gordon Moore is working with big employer groups and insurance companies to set up a larger group of patients (for his study) to validate that this type of practice helps the health of the patients and insurance companies should start compensating more.
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