Re: tact and diplomacy

[Guest guest]

EXACTLY

TSB

--- lawrence lyon wrote:

> let's see--

> since my rep is so well-established, what can i say?

> the fact that some practices, particularly IMP's,

> feel the need to do cosmetic procedures in order to

> make ends meet, is merely another indication of the

> sad state of american medical practice and how we

> are underpaid.

> whether or not one is making it, the choice to do

> cosmetic procedures, or spirometry (as i am

> intending to do), must be consistent with being able

> to look oneself in the mirror every day.

> i just calls 'em like i sees 'em.

> LOLLL

>

> magnetdoctor@... wrote:

>

> Me too, glad I waited, as I was about to say some

> really nasty, and politically incorrect things,

> after feeling like I was called the Devil incarnate

> for doing cosmetic procedures. Thank you , more

> eloquently than I could put it.

>

> Cote' MD

> Four Corners Family Medicine, and Laser Aesthetics

>

> --------- Re: Setting basic

> rules of practice

> >

> > Gordon,

> > Thank you for your response! I do not run an IMP.

> > However, i have been involved an d monitoring this

> list

> > serve for approx 4 years. Implementing alot of the

> > ideas but also attempting to meet the specific

> needs

> > of this community and trying to stay alive.

> > I actually have formidable solutions for the three

> > issues that you present. My main performance

> measure

> > IS pt visits to the ER. I monitor the ER log and

> have

> > found that my patients visit the ER much less

> often

> > than other docs in the community. 1-2 per week and

> > usually it is unavoidable(broken bone, car

> accident)

> > or it is because the patient chose NOT to use the

> > services that I have made available.

> >

> > ACCESS

> > 4-5pm is my " work-in slot " I will see the pt

> before I

> > go home. I am faster, less conversive and right to

> the

> > point but I will see anyone who calls and request

> an

> > urgent visit at that time. Can be 10 at times or

> 0!

> >

> > EFFICIENCY

> > I see the pts who show up on time, on time. With

> some

> > exceptions(emergenies), I do what I have to do in

> the

> > alloted time. Most patients are very appreciative,

> > however, I am the one punished if they do not show

> up

> > on time. Often I remind these pt to be on time and

> > regularly get very crude responses. However, my

> > computer captures all relevant times and usually

> it is

> > clear cut.

> >

> > CONTINUITY

> > I tried a NP and a PA together. Then I spent most

> of

> > my time keeping them happy and paying them my

> profit

> > margin. They are gone. I see everyone and I am

> happy

> > as well as the pt. Previsit protocol sheets make

> sure

> > that I address ongoing issues and capture

> preventive

> > care services. The computer(eclinical works)

> really

> > helps with data management. Not perfect, it still

> > takes a large amount of man power to manage

> patients

> > to the standard of which I strive to acheive.

> >

> > I employee 7 staff to me(one provider)plus a

> diabetes

> > educator and prosthetist(my wife). After several

> years

> > of strategic maneuvering this is the best model

> that I

> > can do and it is working both from a patient

> > satisfaction stand point(yes, i ask) and from a

> > financial standpoint.

> >

> > One hint: I noticed that many of my patients were

> > participating in the local churches LIFESCREEN

> > services(Where a company comes in for cash does a

> > plethora of test on my patients). My patients were

> > extremely aggressive about getting in to do these

> > screenings. Many voiced anxiety about not getting

> on

> > the list. Well, it turned out that I offered the

> same

> > service that these places offered except I went by

> the

> > U.S. preventive task force recommendations. So I

> have

>

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