Why we run late

[Guest guest]

Brady's point was that we are all occasionally late and often for reasons most would agree are justified, but being persistently and systematically late is a sign of an underlying problem that is likely to result in burnout.Persistently late is a systems issue and it has a negative effect beyond satisfaction and burnout. Patients who receive care in practices that are persistently late are less likely to follow through on preventive and chronic care needs, are more likely to skip coming in when symptoms appear minor. This results in missed opportunities for early diagnosis and treatment, inadequate preventive care, and poorly controlled chronic conditions.I would affix much of the blame on the toxic policy and payment environment in which many of us live. One of the common threads on this listserv is the willingness to explore practice models that get us off the hamster wheel. This is a partial solution to the toxic environment and has been successful for some.I recently visited with Queenan in Rochester NY and was thrilled to hear that in her first year she's working hard but earning decent money and loving it. A good part of her professional satisfaction is that her energies are focused more on her patients. This stands in contrast to the the daily grind and entropy of more typical practices.Not everyone on this list is off the hamster wheel. Sometimes a local environment is just too toxic and no amount of efficiency and pruning will solve the problem. Sometimes there is less of a perfect fit between individual capacity and the work required to manage your own practice, sometimes practice startup choices turn around and kill the practice.One of the benefits of this list is to make this journey less lonely, to provide a resource and sounding board for those looking to take the leap, for those in startup mode, for those looking to hone the practice for the long haul. We're compiling lessons learned on the IMPCenter.org site and have our annual IMPCamp coming up in October in Silver Spring MD.I hope to see many of you there. The energy of those in attendance is infectious. Hearing successful IMPs talk about the steps they took and networking make it worth your while.Gordon