An Innovative Medical PracticeOur approach to an innovative medical practice is guided by the model of the Innovative Medical Practice (or IMP, or Ideal Medical Practice, or Ideal Micro Practice) which is being developed by primary physicians and seems to be slowly becoming a nationwide movement. Even the Wall Street Journal is noticing. It aims to:
- Enhance doctor-patient relationships,
- Increase face-to-face time between doctors and patients,
- Run a simple office, with a minimal support staff as a way to keep down our costs and keep down the costs of patient visits,
- Provide patients ready access to their doctor when they need it, using technology and innovative billing plans,
- Produce thoughtful, high quality medical care for patients
- Do all this in a low overhead environment that reduces physician workloads and costs, as well as helps lower patient charges.
- Instill patients with a sense of responsibility for their own health and
- Cut wasted dollars from the current system, which was designed by insurance companies and which has allowed the US to fall so far in its level of health care for its citizens..
One CFO described his hospital's problem being that when a patient comes to the emergency room, the hospical gets $450. But when the same patient goes to a primary care doctor, the provider gets only $50. But this family doctor is supposed be the touchstone for the full medical care for any patient, to take the time to teach and coach the patient to live in a healthy way, to spend time.
You do the math. The system does not work in a way that values reliable, high quality medical care. It loves technology, and seems to get the two confused.
An ideal medical practice is an economically run medical practice and also helps us get closer to the better doctoring we want to give and believe is possible, in the ways mentioned above.
Below is a chart of the characteristics of an IMP compared to a traditional practice. You will notice that the innovations of the IMP are mostly just common sense, and some of these ideas (like seeing fewer patients so you can spend adequate time with each one) are difficult to do in the current insurance system.
|The Mark of an IMP|
|Ideal Medical Practice||Typical Practices|
|Care is driven by the patient's needs, goals, and values||Care is driven by the practices priorities.|
|Access is 24/7||Access is 9 to 5|
|The care team uses technology to its fullest (e.g. electronic health records, email, internet.||The care team avoids new technology.|
|Patients can see their own physician whenever they choose.||Patients must see whoever is available.|
|The majority of the office visit is spent with the physician.||The majority of the office visit is spent waiting.|
|Overhead is low.||Overhead is high.|
|Patients are seen the same day they call the office if they need to.||Patients typically wait for an appointment.|
|Physicians are able to see fewer patients per day||Physicians must generate high numbers of visits per day to cover overhead, even if it means the patient does not get very good care.|
|Practices measure themselves regularly.||Practices have little or no performance data.|
|Practices are proactive in their care of patients with chronic illnesses.||Practices are reactive in their care of patients with chronic illnesses.|
|Physicians are satisfied and feel in control.||Physicians feel harried and overbooked.|
We welcome the input of friends and patients as we pursue this goal.