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Simple, low-cost technologies and strategic outsourcing have helped this solo physician practice efficiently, even without any staff.
I opened a solo family medicine practice in Rhode Island in October of 2004. It's an ultra-solo, no-staff ideal medical practice, also known as a micro practice. Low overhead allows me to see fewer patients per day and spend more time with them, but it also requires that I optimize efficiency in order to accomplish all of the administrative tasks on my own.
Before opening my solo practice, I worked as a salaried family doctor for more than 13 years in an environment where I was completely sheltered from the practice management aspect of medicine. Although I wondered whether I would be able to manage the challenges of running my own practice, I was inspired to make the leap after reading about Dr. Gordon Moore's ideal micro practice in Family Practice Management1,2 and watching a colleague of mine set up a similar practice that has prospered.
The start-up process was relatively easy: I applied for insurance provider numbers, rented some office space, incorporated myself, bought used office equipment from a retiring physician, created a practice Web site (http://nkfp. familydoctors.net) via Medfusion (http://www. medfusion.net) and placed an advertisement in the local newspaper.
Believing that technology is a key to efficient practice management, I also decided to purchase an electronic health record (EHR) system (Amazing Charts; http://www.amazingcharts. com) and billing software (EZClaim; http:// www.ezclaim.com) that interfaced with my EHR. (Total cost for hardware and software at the time of purchase was less than $4,000.) To supplement my income while I developed my practice, I found a part-time job for 12 hours a week at a college health service. Then, in October 2004, I opened the door to my office with a few patients (fewer than 10) who followed me from my previous practice.
Hook, line and sinker, I had swallowed the ideal medical practice bait. I was and remain convinced that ideal medical practices can deliver what patients want and need through the medium of a sustainable and enjoyable practice setting for physicians. However, at the 18-month mark of my new practice, I noticed that although my practice engaged me and provided a level of professional satisfaction that...