What is a medical micropractice and how can I find one in Broward County?
A doctor’s business is known as a “practice”.
Doctors are said to be “practicing medicine” when they work. It doesn’t mean they don’t know what they are doing, it’s just the way we refer to a doctor’s work in diagnosing and treating patients.
A doctor practices medicine in a clinic or a hospital.
In the old days, a doctor’s office was a small and personal space. Patients got to know their doctor very well over a period of many years. The doctor would also get to know the patients very well.
Things have changed a lot in recent decades.
The medical insurance industry has had a significant effect on how doctors practice and how patients see their doctor. These changes have helped in some ways, but not in all cases.
Doctors now tend to work in large medical practices.
They work in groups of many doctors and with other practitioners such as Advanced Registered Nurse Practitioners and Physician Assistants. Some people refer to these medical practices as “big box clinics”.
These are busy places. There are with many employees. They have phone operators, medical assistants, receptionists, billing specialists, referral specialists. You will hear many phone lines ringing. You will see copying machines and a lot of computers.
Even the doctors spend much of their time looking at the computer.
Maybe even more time than they look at patients. The government has mandated the use of certified electronic health records. They enforce this by controlling how much Medicare pays for a doctor’s service of taking care of a patient.
Restrictions are also imposed by private insurance companies.
There are referrals, prior authorizations. There is endless paper work to be maintained. Insurance companies are businesses. Their primary goal is to make money and save money. They often start by cutting back on how much they pay medical practices to care for patients.
The system has become far too complex.
Doctors give in and go to work for companies that manage large medical practices. When the insurance companies reduce how much they will pay per patient, the response by these large practices is to see more patients. The doctors don’t have control of their schedules so they must see more patients when their employers decide that they will see more patients.
Doctors are under tremendous stress.
When you see a doctor in a large clinic, you are often seeing someone who has been squeezed from every direction to a near breaking point. Too many patients, too many regulations, poorly designed medical records software.
Unfortunately, doctors are hardworking, intelligent people who excel at jumping through hoops.
More and more hoops are placed in front of them by their employers, the government, the insurance companies. This is not a good recipe for quality health care. There has to be a better way.
Here is where the concept of a micropractice comes in.
What happens when a doctor walks away from the rat race? How is it possible for a doctor to walk away from the prison of the big box clinic and still be a doctor and care for patients?
It turns out that doctors have been willing participants in their own abuse.
They are agreeing to be victims. Unfortunately, it is not only the doctors who suffer, patients and their healthcare suffer as well. Doctors still have to follow laws and rules of course, but much of the rest can be left behind.
So, what is a micropractice?
A micropractice is a doctor working alone in a small office, just like the old days. There is no huge staff, no multiline phone system ringing off the hook. No complex software tying up more than half of the doctor’s time. The doctor can take the time to sit with a patient and give them the time and attention that they deserve.
A doctor who works in a micropractice may have a receptionist and/or a medical assistant. Or, sometimes, they may work completely alone and handle all of the office duties. Often, the doctor must be creative in making a micropractice work.
How can the doctor leave behind the complexities of today’s healthcare system?
Are they allowed to do that? Of course they are. Doctors do not have to accept insurance. They can choose to accept only certain plans or none at all. Even Medicare can be dropped. The federal government has offered an “opt-out” status that allows doctors to be compliant with the law and still not accept Medicare. By leaving the insurance industry behind, doctors are able to drop most of the complexity that comes with what we expect in a modern medical practice.
Why would a patient not want to use their insurance for a doctor visit?
The concept of a patient using insurance to pay for seeing a doctor for an office visit may be the root of the problem. Insurance in general is intended to protect against the financial impact of unforeseen disasters. For example, we expect our car insurance to pay for accident damage. We do not expect it to pay for oil changes and tire rotation. Our home owner’s insurance covers floods and storm damage. It does not cover cleaning, painting, landscaping and lawn care.
When routine care and maintenance is paid for by insurance, something has to give.
We pay plumbers and electricians for their work. Why not doctors? When you get your hair cut, you will see a state license hanging on the wall that looks just like your doctor’s state license. You pay for your hair cut. Why would you expect an insurance company to negotiate a reduced amount to pay days or weeks later for your doctor’s visit? Do you think that a doctor deserves the same respect as a barber or hair stylist?
When we take out what we refer to as “3rd party payers”, the insurance companies, things become much more simple. Doctors can be doctors. They have so much more available time to sit with you. To answer your phone calls. To take care of your problems and do what needs to be done to take care of your health.
A family doctor does not need a large office staff or even a large office.
A pen and paper in a small exam room with just the basic equipment is usually enough. This may seem revolutionary to some but it shouldn’t.
When you see your doctor, you should be the most important person in the room.
It is not about enriching the insurance companies, the pharmaceutical companies, health care executives and other fat cats. It is about the doctor seeing you as a real human being and taking the time to listen to you and hear what you need to say. It’s about having the time for the doctor to consider your issues and work with you to come up with a plan.
So, a micropractice is all about you, the patient.
It is about making it possible for you to have a doctor again and not just a healthcare system. This does not mean that you should drop your health insurance or leave your primary care physician’s practice. A micro-practice, sometimes known as a concierge medicine practice, is somewhere you can go when you want a more personal experience in seeing a doctor.