Atlas

So far it’s been great here at AtlasMD.  I have spent the last two years as a hospitalist while Dr. Josh started the clinic.  I am happy to say that Atlas has been so successful that I was able to come on as the second physician about a year and a half ahead of schedule.  While I have been here part time for the last several months, I have only been full time for the last two weeks and let me tell you they have been just amazing.  I already knew what it was that Atlas had to offer but to be fully involved has been nothing short of remarkable.  I have been more involved in the meetings with businesses and I have been able to see firsthand the interest that Atlas can spark with them.

There has definitely been a learning curve going from hospital based inpatient medicine back to outpatient but thankfully the office has a pace that allows me to give all the time needed to my patients.  Our software is also coming along and we are working out the bugs in order to make it the best and most fully integrated concierge EMR in any office in the country.  Our patients have been great during this transition also.  As we grow and add services, we are excited to see where AtlasMD will go.  The sky is the limit for us because we aren’t limited by any of the restraints of insurance.  For those of you that have been a part of this with us, we thank you and will continue to deliver everything that you expect and deserve from AtlasMD.  If you haven’t been by to see how we are different, give us a call.  We are always excited to answer questions about Atlas because we are as passionate as ever about changing Family Medicine as we all know it.

Dr. Doug

Not paying is always simple.

The message of this article rings very true for me and supports many of the internal struggles I had while building AtlasMD.   I wanted to solve one of the many problems that plagues healthcare; pricing transparency.

Currently, doctors code every visit by a 5 digit code from one of 15,000 available codes from a list called ICD-9.  Soon the next version, ICD-10 will be released and will balloon up to more than 70,000 codes.   Physicians are stuck in this mindset of complex coding and there will never be an easy way to make that understandable for the patient before they purchase healthcare.

I know that patients don’t care whether their ear infection is a simple or complicated and sure don’t want to risk paying more for a simple distinction without a difference.  The key to consumerism is simple, predictable, understandable pricing which allows the customer to have a foundation of trust in the product.

Hopefully I have succeeded in my goal of clear and simple pricing for AtlasMD.  Flat monthly pricing based on age for unlimited services.

“Good intentions are at least, the seed of good actions; and every one ought to sow them, and leave It to the soil and the seasons whether He or any other gather they fruit”— William Temple

Recently I attended a very informative course on social media by Todd Ramsey (www.thetoddramsey.com).  Among other things, he helped me see that I need to “be intentional” about my social media presence.   I’ve always had good intentions of writing great blog articles or focusing more on my facebook posts, but often failed to act on those intentions.   For now, I’ll fall back on the excuse that I’ve been very busy getting AtlasMD off of the ground, but…(there’s always a but) now I want to show a commitment to my blog.

I’ve always really enjoyed writing and for a long time while in med-school worked for a medical technologies blog, www.medgadget.com. Writing helped develop the creative portion of my mind, which admittedly may need some nurturing.

My goal for this blog is to share my thoughts on how doctors can improve healthcare by embracing sound business principles and to help educate patients and physicians about my brand of concierge medicine.

Look wise, say nothing, and grunt. Speech was given to conceal thought. — William Osler

William Osler was a Canadian physician and one of the founding fathers of modern medicine.  He had the radical idea to bring medical students out of the classroom and into the operating rooms and hospitals.  He was an amazing man, full of wisdom and insight and I enjoy reading about him from time to time.  I’ve always pictured myself as something of a workaholic but I doubt I could hold a candle to Dr. Osler which is why I’m such a fan of this picture.  I think it presents a unique humanity into the loneliness of a physician and all that is required of us to help our patients.   Thankfully, he loved his work and made it his life’s goal to teach others to do the same.

Throughout the centuries there were men who took first steps, down new roads, armed with nothing but their own vision. — Ayn Rand

The above quote is very powerful to me and has served as a source of encouragement as I aim to prove that the free market holds the solution for family medicine.  Dr. John had an excellent blog recently about whether the pioneer spirit in medicine has been choked out by over sight committees and ICD-9 billing minutia and the like.

Some of the greatest physicians of are timed where outcasts because they chose to push the envelope of modern medicine for the sake of their patients.  As a family physician I may not be performing the bench research that may eventually be “the” next big break through.  I do however, feel proud to have a bubbling pioneer spirit to prove that the perfect union of business and medicine will do just as much to improve the health of my patients and many others.

That said however, doctoring is at its best when we try something daring—sensible and thought-out but daring nonetheless.  And when it works, we learn, and rejoice.  Paradoxically, when our efforts don’t work, we may learn even more.

I’ve always wanted to share my personal statements from medical school with my patients so that they could understand why I chose to become a family physician.  Below is the personal statement that I authored while applying to several family medicine programs in my final year of medical school.

Writing my personal statement was something that I had put off for months because I would get a few lines into a predictably rosy explanation of why I loved family medicine and I’d get stuck…I was not in a rosy state of mine and it felt to insincere to gloss over my true feelings.  Ultimately however, coming to grips with my emotions helped me to truly see through the grit and reminded me about my true love of family medicine.

Medical school is not easy.  To describe the experience merely as ‘stressful’ would be a gross understatement.  Often I cavalierly joke that a part of me died during the rigors of that first year.  Furthermore, as I stand on the threshold of a career in medicine the future fails to appear any more optimistic.  All too often, it seems that the lofty ideals which have become cliche in med-school applications are lost somewhere along the way.  So as I sit here, reviewing my original personal statement, I am forced to examine whether I am as motivated as I was prior to the stressors of medical school.  Thankfully I can say that I am.  If anything, my passion for people has grown/matured.
“Don’t loose your heart” Traudle, friend & neighbor

Traudle is an older, divorced, eccentric German woman who was my neighbor for six years and the inspiration for my original personal statement.  I affectionately refer to her as my ‘first patient’ but it would be more accurate to call her my ‘first medical professor.’  During the winter of my sophomore year at K-State, Traudle suffered a severely broken wrist and I was by her side from the first ER visit, to surgery and through months of rehab.  Initially, she taught me what it meant to be a patient, complete with the inherit joys, sorrows, and frustrations that one would expect.  However, now I reflect on what Traudle can teach me about what it means to be a physician.  The Traudle that is my neighbor is a warm, kind, hard-working woman with an ‘old country’ view of the world.  The Traudle that could walk into my clinic is a nervous, minimally educated, untrusting patient that would show up late, stay too long, and monopolize my time.  Understanding this dichotomy reminds me that even difficult patients may be good people who are uncomfortable in a stressful medical environment.

“A merry heart doeth good like a medicine” Proverbs

Very early into my third year, I was rotating through Psych Consult and was asked to speak with a 45 year old woman for possible depression.  I can’t help but think that my lack of clinical skill was as obvious as the nose on my face.  However, I learned a warm smile and a sympathetic ear can be surprisingly therapeutic.  After two days and several hours of discussion, this patient felt comfortable enough with me to reveal for the first time ever that she had been extensively molested as a child.  This was a truly profound experience that emphasized that the ability to communicate with people is the essence of the art of medicine.

I’m not naive; I read the near daily articles preaching the woes of primary care physicians.  I’m painfully aware of the declining interest in family medicine, pitiful reimbursement, and the looming extinction of the solo practitioner.  I’d be a fool if I didn’t ask myself why I would volunteer for a specialty wrought with such difficulties.  Simply, my answer is ‘the people.’  I am wholly willing to sacrifice the perceived financial and personal perks of another specialty in exchange for the intimate experience of my patients.  Additionally, I believe that the future of family medicine is brighter than forecasted and I look forward to being actively involved in its revitalization.

“Procrastination is the grave in which opportunity is buried.”  — Author Unknown

As the dawn is breaking on 2011, I can honestly look back at 2010 and be proud of all that I was able to accomplish.  It was a busy year with the birth of my first son and third (likely last) child, an intense moonlighting schedule, began building a practice while finishing residency, and finally launching a new clinic with all of the joys and challenges expected in such a venture.  Although I’m happy with how much I was able to achieve, I know that procrastination is a crutch of mine.  There is so much more that I would like to do on personal and professional levels that I should be able to complete if I choose to make it a priority.

Goal setting 101 says to make specific, achievable goals so my goal for January is to blog [near] daily to get over the hurdle of “just starting.”  I apologize if the blogs seem disorganized or brief at first but I hope that practice will help make perfect.

Writing as long been a personal joy of mine that I rarely get to do as a busy physician.  This likely comes from the fat that my father is a lawyer and my mother an author.  Throughout my life I’ve found solace in expressing myself in writing either for fun or profit.  For several years during medical school I was fortunate enough to be an active editor for one of the top medical blogs, www.medgadget.com, which was an amazing experience.

The Happy Hospitalist has a very interesting piece today about the abuse and misuse we witness daily in medicine.

In a land of social solidarity, those with means feel an obligation to provide for those with less resources, outside of government control, but those of limited means also feel a sense of obligation to limit their consumption of  resources.  In America and America’s health care reform, those with means have been taken hostage out of force to pay for those with less resources.  However, there is no sense of moral obligation by those receiving the fruits of other’s labors to limit their consumption.

Here is a very well done video that simply and clearly explains how concierge medicine works and how you may benefit from it.

“…Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it–and still less safe, if he is the sort who doesn’t…”