To the Editor:

I read “14 Alternative Practice Styles” [February 2001, page 33] with interest and wondered where I could get more information about practicing as a “free-range physician.” It seems like you’d need more than a car, laptop and cell phone. How do free-range physicians handle billing and malpractice insurance? How does a call schedule work? How do they promote themselves to the patient community?

Author’s response:

You’ll need to submit your own charges and arrange your own malpractice insurance. You could field all of your own telephone calls after hours but refer patients needing immediate care to a local urgent care center, ER or hospitalist. A call group that covers each other’s vacations would allow you some time away. I have known some doctors who use a local “ask-a-nurse” as their first-line call coverage and then take the calls that exceed the ability of the ask-a-nurse service. You might decide to find a partner to go into free-range practice with you.

To build your patient base, you should promote yourself like other physicians in private practice. Consider the phone book, print ads, billboards and radio spots. Word-of-mouth and physician/nurse referrals will remain important sources of new patients. Long-term relationships with facilities such as nursing homes will also generate significant patient volume.