Ideal Medical Practice

An Ideal Medical Practice, aka Micro practice, is a new medical practice model that focuses on reducing overhead, increased utilization of technology and improving the patient-physician relationship.

Traditional Practice

Office based Family Medicine practices of today are increasingly adding extra services and features. Many physician offices have their own fully functional laboratories, radiology services (including CT scanners), Physical therapy and Occupational therapy rooms, and even endoscopy suites. Many patients prefer the one stop shop convenience of all of these services in one place and physicians will usually see an increase in their bottom line. However in order to financially justify having a CT scanner or a half-million dollar laboratory machine, a doctor has to increase revenue. Physicians are somewhat hindered when it comes to setting prices for services, as this is highly regulated and negotiated by insurance companies and the federal government. So the main way that a physican increases revenue is by increasing patient volume. This often translates into physicans seeing upwards of 50 patients a day. If the physician cannot generate enought volume to overtake the overhead then nurse practioners or physician assistants must be added to accommodate more patients. As the volume of patients that one physician is responsible for continues to rise more nurses, billers, coders, administrators, secretaries, office space, and electric usage are needed. This increase in staff adds more expense to the overhead of the physican furthering the need for more patient volume and the vicious cycle continues. Patients tend to become less satisfied over time with this model because the physican spends a limited amount of time with them. Often the patients must see the physican assistant or nurse practitioner instead of their regular doctor.

Basic Concept

An Ideal Medical Practice (IMP) has a different business philosophy than a traditional practice. Instead of focusing on increasing patient volume, the IMP attempts to drastically reduce overhead. This means eliminating extra radiology, lab and other extraneous services. Nursing staff and office staff are reduced or eliminated entirely. Office space is reduced to bare essentials. One may ask how can the Ideal Medical Practice afford to eliminate these essential staff members? The answer is simple, utilizing technology to the fullest.

Technology
With the technologigal explosion that occurred in the United States most industries have rapidly and efficiently incorporated technology into their work environments. The healthcare industry, as a whole, has significantly lagged behind. It is essential for the Ideal Medical Practice to fully utilize technology to the fullest to get the maxiumum benefit for overhead reduction. The most essential and central technology in the IMP is the electronic medical record(EMR). The electronic medical record allows increased efficiency and reduced amount of mistakes over handwritten notes.

In order to begin to eliminate staff members from the clinic various software programs must be utilized. Starting with the scheduling, in the IMP the patients will go online and perform many of the tasks that front desk staff completed previously. Through various web based applications the patient will make and cancel their own appointments. Patients will also check in online before coming to the office, filling out all of the necessary paperwork beforehand. With open access scheduling, patients will usually get into the office the same day that they make the appointment. The patients may even fill out the subjective portion of their history using algorithmic question strings. This could be interfaced with the EMR so that this information appears in the physician's note before the patient even arrives.

Triage is handled with programs that take all incoming calls, faxes, and other communication and reformats and redirects them into your email. This allows the physician to have all information that comes into the office already be in digital format and can easily be added to the medical record. Additionally medication refill requests can be quickly cross referenced with the EMR and responses faxed to pharmacies. Incoming laboratory results can be forwarded on to the patients and placed into the EMR simultaneously.

Billing can be generated automatically from information gleened from the clinic note. Once again this reduces the need to pay for an individual to do a job that can be automated using software. By reducing the need for employees, subsequently the need to see a high volume of patient decreases.

Improved Patient Relationship
Allowing more time to spend with the patients allows the physician to get to know their patients better. This improved level of understanding builds trust. When patients trust their physicians and respect their opinions they are more likely to open up to the physician where they might not have before. Patients who know their physician better are more likely to adhere to treatment regimens. The additional time that physicians will have with their patients allow them to explore beyond the chief complaint and talk more with the patients about preventative medicine. In triage situations where the patient calls in requesting information or advice the patient now has a direct line of communication with the physician. By eliminating the middle man from the message taking communication errors are significantly reduced.

Patients are more satisfied and feel more in control of their healthcare. They feel their doctors more completely answer their questions and more thoroughly deal with their medical problems. Physicians are able to feel more fulfilled and avoid high-volume burnout.

Better patient outcomes
By introducing an electronic medical record, many errors are reduced or eliminated. Automated health maintenance systems remind physicians to ensure that patients receive the screening and education that they need. The extra time during a patient encounter facilitates more comprehensive care which leads to more preventative medicine.

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