I was a physician employee, many times for many hospitals and clinics. I’d stay a year or two, but eventually I’d quit. Then, in 2005, I opened an ideal clinic designed by my patients. Ten years later, I still love private practice. Why? I’m finally practicing medicine the way I had always imagined.
When I decided to open a private practice, I was determined to do things differently. I needed to know what my patients really wanted from me. So I led a series of town hall meetings where I invited my community to design an ideal medical clinic. I collected 100 pages of written testimony, adopted 90 percent of the feedback, and opened one month later. Now my job description is written by patients, not administrators. I’m finally the doctor my patients had always imagined.
I work collaboratively with my patients in a neighborhood family medicine clinic where nobody is turned away for lack of money. It is ideal. There are so many things I love about private practice. Here are a few:
• Autonomy. No more committee meetings. If I want to change an office policy, I just do it. I don’t ask permission for time off. I just take off. Fortunately, I rarely feel the need for a vacation since I work a humane, part-time schedule (20 hours per week, including administrative work). By the way, I’m in control of my schedule. I never double-book. I’m never rushed or frazzled.
• Disintermediation. By “removing the middle men” and no-value-added intermediaries, I now have more direct relationships with my patients. They requested a simplified, small office with less staff running around. So now I’m a solo doc with no staff. I don’t miss the layers of bureaucracy and administration. Nor do my 500 patients who get uninterrupted 30-minute to 60-minute appointments. I do accept most insurance plans; the ones that don’t require hoop jumping through a gazillion unfunded administrative mandates.
• Finances. Because I’m no longer supporting a bloated bureaucracy that does not support me or my patients, I have extremely low overhead. As a result, I’m taking home three times as much income from each patient visit than I had taken home per visit in my high-overhead employed positions. Yep. I make more money seeing fewer patients and I do this without charging patients any extra fees.
• Authenticity. I dress casual, not corporate. I’m usually in Levis and clogs at work; so no white-coat hypertension. My patients appreciate that I dress like a real person. One woman exclaimed, “It’s so refreshing to meet a doctor who is a real person with a real personality.” I like being me. Why hide from my patients? I’ve never practiced professional distance. I believe professional closeness is most therapeutic.
• Fun. I have a gift basket in the exam room with prizes for patients who have lost weight, quit smoking, or achieved other health goals. Patients also receive gifts if they bicycle or walk to the office. I host random “Patient Appreciation Days” with balloons and dark-chocolate treats. I even throw clinic holiday parties — all patients are invited!
• Inspiration. What I love most about my practice is that I’ve stopped complaining about medicine. After all, if doctors are victims, patients learn to be victims. If doctors are discouraged, patients learn to be discouraged. If we want happy, healthy patients, why not start by filling our clinics with happy, healthy doctors? By enjoying private practice, I’ve inspired my colleagues to start enjoying their own careers again. Some have opened ideal clinics. Some docs have told me that I’ve saved more than their careers — I’ve saved their lives.
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Pamela Wible, MD, is a family physician in Oregon. She hosts biannual physician retreats to help medical students and physicians overcome burnout, depression—even suicide—so they can be happy too! Contact Dr. Wible for a free initial consultation on how you can be a happy doctor 🙂 Photo by Geve.
I understand the assembly line medicine/healthcare system since I was a participant in it for nearly 10 years. Now I am off having declared myself a human being instead of a gerbil on a wheel. I moved to Benin West Africa to be a medical provider to Peace Corps volunteers. True most of the volunteers are healthy with a few tropical illnesses thrown in and the ubiquitous diarrhea. Medically it’s not very exciting or varied But it gives me a chance to breath , use my mind, body and spirit in a new way. I am breathing for the first time in years and educating people about how much a nurse practitioner can do, teaching young people how to care for themselves and learning more than I could ever anticipate I am grateful for having the courage to jump off that wheel and appreciate how much I truly care for people and myself. So why do the rest stay in this system because we all know this is not what any of us signed up for?It is such a disservice to our patients and ourselves. I
Know when I return to Oregon I will have the courage to work on my own terms and have an independent practice. Following you Pam and all those who respond to this site over the last two years, has helped me see this. Thank you, au revoir for now
YAY! Carolyn you can do it! Call me when you get back to Oregon 🙂
I am proud, Pamela to be a part of the ideal medical care system. I use the same six principles in order to control my life and do part time medicine. I’m happy and I don’t know what a white coat looks like. Never wore one and I never will.
I control my own finances and now enjoy I enjoy greeting and treating my patients as friends. They are the ones that trusted me and I have returned that trust with service.
I am impressed by your Disintermediation and No Staff policy! Your 20 hour week schedule gives breathing room to enjoy your life and be happy.
As an autonomous physician, you can change your policy suit your needs in regards to day to day operations.
Congratulations to you, Pamela! Your will to survive in this medical climate is most admirable!
Happy to be in this medical climate is most admirable!
Happy to be a supporter of Ideal Medical Care!
John
Boy do I wish I worked with you. Your practice model is one to be emulated, for sure. I work in a very nice clinic, but am ready to throw in the corporate towel (and white coat.) it is literally killing me.
Call me! Seriously . . . 541.345.2437 . . .
🙂 I got the 53-second solution! Have you seen this? –> https://www.idealmedicalcare.org/blog/ideal-clinics-the-health-care-model-that-works/
Dr. wobble, my name is Marie and I’m a PA-C. I live in Coarsegold, and work in a medium-sized clinic in Oakhurst, CA. I am very disillusioned in medicine. Worn out. Underpaid. Overworked. Sick. Constant headaches, now hypertension and tachycardia. Depressed, and yes, at times wish I just wouldn’t wake up. I am interested in what you have to offer. You can call me; my phone number is (559) 760-4220. Marie
(559) 760-4220 cell. Marie
While this model works for Pam, I want to encourage an “in between” model for most of us. I am a solo, working for myself, in Western PA. I DO have staff, but we are not an “assembly line.” I see at most 50 pts a week (would like to see more and will at times), 4 days a week (AM Monday and Thursdays I am doing support functions, mainly from home).
While I would admit it is challenging at times, with a 60% overhead, after 11 years I still am thrilled to be involved with pts’ lives. I mostly take care of adults and late teens (vaccines are impossible to purchase for the under 15 crowd except 1 at a time).
So I support the INDEPENDENCE of physicians/providers everywhere, and hope to be an asset to Pam’s mission in the future. Pam has invited me to speak at her fall seminar at a distance and I will hope to be there.
In the meantime, those of you “in distress” if you are evaluating upcoming opportunities I would be pleased to help out, especially with contracting issues. I am not an attorney but I find I have an affinity with helping the “younger crowd” survive this time of great stress but great opportunity.
We are at a “tipping point” folks! Don’t dispair. Be rejuvenated.
May we live in “interesting times” is not always a curse!
Dr Matt Levin
Western PA
May all of our models inspire others to innovate and create what will work for their communities. Happy & healthy doctors = happy & healthy patients. Thanks Matt!
Do you have retreats for burnt out pain patients? I’m serious. I do poorly on opioids (Migraines, loss of appetite, nausea). I need a retreat for my problem.
Respectfully yours,
Thea
No. I’m 24/7 on doctor suicides right now. Maybe you could start a retreat for pain patients.
Very educated article. A lot of information on how to be a happy doctor. Thanks for sharing.