Are you receiving health care or abuse? →

Abuse ScheduleA physician in Texas posts this photo on Facebook. Caption: “My schedule one morning in January 2014. Never again . . .”

Yay! Another physician breaks free from assembly-line medicine.

High-overhead, high-volume offices sacrifice the sacred physicians-patient relationship and perpetuate a disease-billing management system. This is NOT health care. It’s abuse.

Patients: avoid clinics with 10-minute slots. Go for docs who offer 30-60 minute appointments. Physicians: stop following the same old practice management advice. Follow you Facebook friends. They offer the best support and business tips:

This is so sad!!!!

I can’t believe people practice like this! Every 10 minutes??? We’re doctors, not robots!

And this is what people have to spend their hard earned money on insurance for. Pretty sad, but mostly sad for the exhausted doctor who can’t possible be making a difference in someone’s life with 10 minutes.

Throw in a cumbersome EMR and that’s a recipe for surefire burnout by 10 am!

I was a medical assistant back in the day for a physician who kept a schedule like this. This is an impossible schedule to maintain and just sets up a system where the individuals involved with providing care constantly feel like they are failing. Very demoralizing. Very depressing. Definitely not a practical approach for the patient or the physician (and his/her minions). I used to get chastised for taking “too long” to collect a patient history (even five minutes was considered “too long”) and the physician told me I had to “stop talking to the patients so much.” I told the physician that there was no way to get an accurate history without talking to the patients for more than five minutes… the physician told me I would “eventually grow out of my need to talk to people.” Ha. Wrong.

This makes me want to cry.

This has been normal for the state NHS GPs here in the UK for over a decade! Only now are they burning out as the state wants them to do surveys, audits, med reviews, etc as well as consult with the pt in the same 10 mins!

Obscene.

This is crazy, not only does this burnout the physician but how on earth can any true healing happen with type of schedule, no time to even talk to them no wonder the country’s health sucks and we spend so much money because there is no healing in the business of medicine.

Welcome to my world. Friday, like too many days, I did not get to pee or have a sip of water…eating almost never happens and a “lunch” doesn’t exist… I felt like I was in solitary confinement. Thank God I still love what I do and love my patients—these are the only two things that keep me going.

That’s nuts!

Yes, and the amount of documentation required to be reimbursed adequately for that 10-15 min visit takes about 25 mins each patient unless you can stomach being a fraud (which I cannot) so then you’re perpetually behind on that, so…the cycle is very dissatisfying and makes a lot of us wish we had chosen another career option, but then we realize that our medical school debt is so deep that there is no other option for us, so we carry on…  🙁

When did this great country become a country of wimps and sickly people?

Dear physicians, NPs & PAs: PLEASE rebel when the bean counters try to do this to you.

We write our own stories through the choices we make.

You have the power to say NO!

Pamela Wible, M.D., is the founder of the ideal medical care movement. She teaches physician retreats where she helps physicians reclaim their lives and their careers—so patients can finally get the care they deserve.

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The #1 thing patients want from doctors →

Ever wonder what patients really want from doctors?

Is it the fancy buildings with marble fountains?

Is it the board certifications and diplomas on the wall?

Is it the expert medical jargon and starched white coats?

Nope. None of the above.

Listen up, docs: Patients just want the real you. Ya know—YOU. The competent and caring you who really listens with compassion. The real you that talks like a real person and answers people with the honest truth in words they understand. The you that treats patients like family.

Does it matter if you’ve got glitter on your eyelids? Or if you come in after hours in sweatpants? Or if your kid tags along with you to work? Actually patients think those things are kinda cool.

So how do I know what patients want? I ask them. And what they want more than anything else is a doctor who is courageous enough to be real.

Doctors don’t seem to know this.

I’ve attended lots of medical meetings and sat around conference tables with physicians trying to figure out how to gain market share, how to get great patient satisfaction scores, how to bring in more revenue.

At one such meeting I sat with 12 physicians and a frazzled secretary frantically taking notes. The docs decided that we should all take a special test so we could become “experts” in diabetes and put our diabetes certificates on the wall to impress patients. As I raised my hand, all eyes turned to me and I shared, “Patients don’t really care how many certificates you have on your walls. What people want is 5 more minutes of your time. They really just want you.”

The room went silent. Blank stares. The secretary even put down her pen. Then the conversation picked up right where they left off in pursuit of their special diabetes certificates.

Meanwhile I had recently opened a clinic designed entirely by patients. I was making more money. And working less. Plus I was in such high demand that I had a waiting list—a really, really long waiting list.

My waiting list quickly exceeded the number of patients in my care. Folks even tried to bribe me to get to the top of my list. I told one gal it would probably take 5 years before I could see her. She said, “No problem. I’m not moving. I want YOU to be my doctor. Put me on the list!”

I have no diplomas on my walls.

No special certificates.

No white coat.

Just jeans,

glitter

and

a

smile.

The magic formula is YOU.

pAM_star_WEB_CROP

Pamela Wible, M.D., is a family physician and pioneer of the ideal medical care movement. Attend her physician retreat and learn how you can have an ideal clinic too. Medical students are welcomed.

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7 steps to get what you need from your doctor—fast! →

7 steps to get what you need from your doctor

Sick of phone trees, endless refill requests, packed waiting rooms, out-of-control bills, and other medical misadventures?  Follow these 7 simple steps to get your doctor to do what you want.

1. Get Organized. Be clear about what you need from your appointment. Make a comprehensive list of all the issues you want to discuss—and your ideal outcomes for each. Patients who are proactive and organized can cover twice as much in an appointment compared with patients who are passive and unprepared.

2. Prioritize. Organize your list. Assign numbers to each problem in order of significance to you. Now scrutinize your list for conditions that may be life threatening. Move those to the top. This is the order of significance for your doctor. Highlight the top 3 and handle remaining items as time permits.

3. Start early. The best time to see a doctor is early in the day. Twenty percent more polyps are found on colonoscopies before 11:00 am. Why? Physician fatigue. Need your physician’s full attention?  Mondays and Fridays are the busiest days so schedule your appointments on midweek mornings before 11:00 am.

4. Be human. You need a physician, not an automaton. But many docs feel more like factory workers practicing assembly-line medicine. Jolt your doctor out of the robotic technician role by making a human connection in the first 30-60 seconds of your visit. Start with a joke, a poem. Bring a smiley-face balloon or homemade chocolate chip cookies. Humans bond over food and fun. Try it.

5. Be direct. Now that you’ve got rapport, share the top 3 items on your list—and your desired outcomes—in as few words as possible. If you prefer not to take drugs, state that immediately so your doctor doesn’t go on a detour discussing medications. If you want a referral to a physical therapist, say so upfront. Just want reassurance, ask for it. You’re more likely to get your needs met quickly by stating your intentions directly.

6. Plan ahead. To avoid multiple visits, consider your medical needs over the next 6 – 12 months. Ask for refills at your visit rather than calling later. Are you likely to have a flare-up of a chronic condition in the next year? A bad back? A panic attack? Prevent midnight trips to the ER by getting emergency medications now.

7. Say thank you. End appointments with this sentence: “Thank you. I really appreciate ____________.”  (Fill in the blank). If you can’t say anything nice, find another doctor.

And if your doctor looks terribly distressed, hand your doc my phone number: 541.345.2437. I help physicians off the assembly line so they can enjoy seeing patients again. You just might save your doctor’s life!

Pamela Wible, M.D., is a family physician and pioneer of the ideal medical care movement. Join the movement to deliver ideal care to all Americans!

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7 Secrets to Loyal Patients for Life →

LoyalPatiets

Loyal patients are the lifeblood of a medical clinic. And devoted patients are worth their weight in gold. It’s a lot easier to care for an established patient that lots of one-timers who never return. Beyond ease of workflow, the economic benefits are fabulous. A loyal patient panel will stay with you (and pay you) through sickness and in health even if you don’t take their insurance—even if you choose to go cash only. Loyalty is earned. So what should you do? Follow me:

1. Solve problems. Physicians must solve their patients’ chief complaints. Don’t get distracted by one-size-fits-all algorithms and computer prompts. Treat the patient, not the computer, not the insurance company.

2. Return calls. If a patient calls, call them back ASAP. Return emails, labs, and test results the same day. Sooner is better. Patients get anxious when left waiting.

3. Start on time. Respect your patients’ time by staying on schedule. If you run late, apologize. Better yet, offer a $5 gift card for a cup of coffee. When I run late, my patients choose handmade soap from a giant wicker basket. What will you do?

4. Stay put. If you want patients to stop doctor shopping, then doctors should stop job hopping. Jumping from one clinic to another isn’t a winning strategy for a loyal following. Find or create an ideal clinic and stay there.

5. Have fun. Nobody wants to see a doctor who is stressed and depressed. Smile. Laugh. Tell a joke. Lighten up. Host a patient appreciation day every once in a while and hand out balloons and chocolates—just because!

6. Research & refer. If you can’t solve a problem, research and refer to someone who can. Reach beyond allopathic medicine when needed. Refer to acupuncturists, massage therapists, and other health professionals. Replace, “We have nothing left to offer you” with “I’d like you to see my colleague who has had some incredible success treating your condition.” Never abandon your patients to Dr. Google.

7. Do house calls. You’ll basically stand out as the town hero when you treat a patient in their home. Try it weekly—even monthly. I bet you’ll love it!

Patients are routinely held hostage on phone trees and in packed waiting rooms, in paper gowns and cold stirrups. Believe me. It doesn’t take much to wow your patients. In fact, now I even get tips! Yesterday, I  got an $80 tip on a $95 bill. Follow my strategies and you’ll get tips too! And you won’t even have to put out a tip jar 🙂

Pamela Wible, M.D., is a physician entrepreneur and pioneer of the ideal medical care movement. She teaches physicians cutting-edge business strategies at her biannual physician teleseminars & retreats. Join us anytime! Medical students are welcomed.

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22 Comments

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Why medical conferences feel like funerals →

DeathByDespair

A friend just got back from a big medical conference at a fancy hotel. The cleaning ladies actually pulled her aside to ask, “What’s with all the grim faces and sad eyes?”

Do doctors realize medical conferences look like funerals? That’s what the cleaning ladies think. I bet they’re not the only ones.

Why do medical conferences feel like funerals? Maybe because doctors are dying by suicide at twice the rate of their patients.

Why?

The truth is doctors are dying from despair.

I attend lots of conferences. Writing conferences. Entrepreneurial conferences. Marketing conferences. I’m fueled by the energy and enthusiasm of authors, entrepreneurs, and business people who are so darn passionate about what they do in the world.

But I avoid medical conferences, and here’s why: the energy is low. Doctors look depressed, defeated, checked out. I’m naturally a hypomanic optimistic, and even I have to admit—most medical conferences make me feel sad.

Don’t get me wrong. I love the hotels. Meals are superb. My pillow is nice and fluffy. The medical content is enriching. But the doctors look miserable. I could reference their clinical symptoms in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), but if the cleaning ladies are so worried about us that they’re questioning our mental health, maybe we should stop diagnosing patients for a moment and examine ourselves.

Health care is making doctors sick. Even suicidal.

I was once a depressed and suicidal doctor. I thought I was the only one. Now I know depression and suicidal thoughts are an occupational hazard of the medical profession. Let’s face the facts: it’s depressing to be surrounded by sick people all day without enough time to care for them—or ourselves—in 7-minute office visits. And if we seek mental health care, we face real retribution and license restrictions.

Doctors are fed up with assembly-line medicine. The solution I found for my own despair is simple. I went from suicidal to successfully self-employed in six weeks! I took a leap of faith and invited my community to design their very own medical clinic! In less than 30 days we opened the first ideal clinic designed entirely by patients. I’ve never been happier.

Since opening our community clinic 10 years ago, I’ve helped doctors open ideal clinics all across America. In my travels, I meet lots of physician entrepreneurs. They all have one thing in common—they’re happy!

Our medical training doesn’t teach us the business skills we need to thrive as physicians today. Maybe doctors should attend fewer medical conferences and more entrepreneurial and marketing events. Hang out with happy people who love their careers and see what we can glean from them.

For now, I’m going to continue to do my continuing medical education online.

Pamela Wible, M.D., is a family physician and founder of the ideal medical care movement. She offers bi-annual retreats for medical students and physicians who want to learn the business skills they need to be open their ideal clinics.

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