Jeff Goldsmith, PhD, associate professor of public health sciences at the University of Virginia, author of the other report, agreed. "Medical practice innovation holds the key to private practice being a viable alternative to salaried employment for the next generation of physicians," writes Goldsmith. "It holds the promise for both diversifying physicians' service offerings and for improving physician productivity."
In the reports, the authors offer suggestions for physicians that they should consider now, to get a handle on their practices—before they decide to get out of the business of caring for people. They cite physicians who "bucked the trend" of leaving and have maintained a sustainable practice. Among their immediate suggestions:
1. Fix your practice. It's like cleaning house, taking note of what can be quickly improved, for greater efficiency. You may decide you like what you have after you make tweaks—some large and small—involving paperwork and employment of staff. It includes contracting out billing and collections; collecting co-payments and deductibles at the time of service; reducing or cross-training administrative staff, and employing mid-level providers.
2. Try a new practice model. Consider launching an extremely no-frills "micropractice " or concierge practice. The micropractice model is basically a solo practitioner who has no staff, with low overhead, who sees fewer patients each day and spends more time with them when they visit.
It's curtailing the stress and spending more time on care. Isaacs and Jellinek noted a 57-year-old Chicago physician who talked of his "ideal medical practice," in which he sees just 15 patients a day and spends an average of 27 minutes with them.