Washington Post Profiles Physicians Who Have Adopted 'Micro-Practice' Model

Main Category: Primary Care / General Practice
Article Date: 27 Aug 2008 - 4:00 PDT

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The Washington Post on Tuesday examined how "in the midst of the national dialogue about quality and systemic reform, ... countless doctors, generalists and specialists alike are ... reinventing their clinical practices and finding more effective and more fulfilling ways of practicing medicine" that focus on patient-centered care, chronic disease management, self-care and medical homes.

The Post profiles Ramona Seidel's Bay Crossing Family Medicine in Annapolis, Md. Seidel left a traditional group practice to start her own "micro-practice" -- a "low-overhead, high-tech office that gives her more control over how she treats patients and more time to spend with them," the Post reports.

The Post also profiles Anna Maria Izquierdo-Porrera, the former medical director of two Spanish Catholic Center clinics serving low-income immigrants in Washington, D.C. In an effort to improve patient care, Izquierdo-Porrera referenced quality improvement data and enrolled in a program through the Institute for Healthcare Improvement that teaches people how to apply business-operating strategies to clinics. She also implemented electronic health records to track patients with chronic diseases. As a result of the changes she made, waiting times at the clinic have been reduced, patients often can get appointments on the same day "and a single clinic visit may include follow-up tests, consults and referrals to specialists, including several who volunteer at the clinics," according to the Post. The Post reports, "This efficiency is crucial to low-wage workers who might have difficulty missing work for health appointments and might delay getting treatment needed for chronic conditions."

IHI President Donald Berwick said, "The way the average office practice still works, it's almost indistinguishable from the early 1900s, minus the computer screen," adding, "We're practicing horse-and-buggy medicine in the space age." He added that reducing or eliminating wait times, having e-mail and telephone consultations, and improving staff efficiency enables physicians and nurses to spend more time with patients. He said, "The same things that frustrate patients frustrate the doctor. The dropped balls, the long waits, the missed communication, the poor communication" (Kenen, Washington Post, 8/26).

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