Mar-Apr 2014 Table of Contents


Joy Revisited

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If we want joy in practice, we're going to have to try a different approach.

Fam Pract Manag. 2014 Mar-Apr;21(2):36.

Author disclosure: no relevant financial affiliations disclosed.

Things can seem pretty dismal in primary care these days, so plenty of folks have been offering advice on how to reinvigorate the joy of practice. Some have said we should slow down, pray, be mindful, or use laughter. Others have said it is more about how we run the office, so we should reduce our overhead (e.g., empty our own trash) and work to the top of our license (e.g., let someone else empty the trash).

I have a solo practice with a few staff that I use in innovative ways. I work in the third poorest county in a state that is 30th in per capita income. Over the last eight years my income has risen, and though I cannot make what an employed (i.e., subsidized) doc makes, I do OK. My quality is good and costs are low, and I spend a lot of time with my patients. I measure, tinker, and redesign continuously. I have a cool practice. I might have joy. Except.

Except that if we really want joy in the practice of a very tough job, and if we want to encourage young people to join us, then we need a better job and the tools to be successful.

Except that without simple, meaningful metrics for primary care, we end up reporting hundreds of meaningless measures (such as how

About the Author

Dr. Antonucci, a family physician, is in solo practice in Farmington, Maine. She wishes to acknowledge L. Gordon Moore, MD, for his mentorship and permission to borrow key phrases.


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