Marc Price, DO, says he was a family physician even before graduating medical school in 1999. In private practice in Malta, N.Y., Dr. Price worked for a large group practice before deciding to open his own, solo practice. Dr. Price sees about 100 patients per week in his practice, and said it's the clinical patient interactions that attracted him to family medicine. He is also heavily involved in advocacy efforts on behalf of family medicine, serving on the AAFP Commission on Governmental Advocacy and the New York State Academy of Family Physicians Advocacy Commission.
Q: What led you to practice family medicine?
Dr. Price: When I first decided to dedicate my life to the practice of medicine, I had all intentions of becoming a surgeon. Orthopedics and plastics, in particular, held my attention. I even started my first year of training as a rotating intern in an osteopathic surgery program. However, after spending my first few months tending to pre- and post-operative patients on the floors and then going through a rotation in the family medicine clinic, I enjoyed the clinical patient interations even more. It was then that I explored, and obviously changed career paths toward, family medicine.
Q: How do you make the private practice model work for you and your patients?
Dr. Price: I started out my career as part of a large group practice. The medicine practiced there was top-notch and I had a good relationship with my coworkers. I did well in the practice environment and was even offered partnership. However, despite this, I desired more control over how I practiced medicine and when. I decided to start my own practice for those and many other reasons. It was a tough journey, but opening my own practice was one of my most rewarding professional accomplishments to date, and continues to serve as a source of pride. I make the model work simply by listening to my patients' wants and needs. The medicine I practice is the same as when I was at the larger practice, but now the delivery is different. I provide care and services to my patients as I would like to receive them. By having control over how the office runs, my office is able to communicate more effectively and efficiently than many larger practices and we're able to adapt and change very quickly when change is necessary. Also, by being able to control the business aspect of the practice, I can better make decisions on how to provide the best for both my staff and office, as well as my patients.
Q: What do you wish you knew when you were in medical school?
Dr. Price: What I wish I knew in medical school was the power that a medical student posessed. Then, I used to take all of my given responsibilities (collecting lab and test results and performing undesirable but necessary tasks) with grave seriousness, but failed to garner as much knowledge and trainig from those events as I could have. Instead, I approached my tasks as a job needing to get done rather than a learning experience. The advice I would have given myself is the same advice I now give to medical students. I tell them to do their job, and that is to say, be a student and learn. If they are performing a task without a benefit, they might as well not be there. Every experience is a learning opportunity with which to expand their knowledge base. If they don't see the immediate and inherent value in a task, they should ask the supervising physician what they are supposed to be learning. If they are collecting test results, have the supervising physician review results with them. They are paying for their experience and deserve to get a return on their investment.
Q: Describe a typical day for you.
Dr. Price: On a typical day in my office (if any day is truly "typical"), I arrive at 7:20 a.m. My first patient is scheduled at 7:30 a.m. My day is scheduled so that I finish seeing patients around 4 p.m., though I usually run about 10-15 minutes behind. I have one late night when I stop seeing patients at 7 p.m., and one half-day when I finish at noon. Although I answer messages, review and comment on labs, tests and consultant notes and fill out forms throughout the day — either between patients or during my lunch hour — I am usually in my office for one to 1.5 hours past when I finish seeing patients to finish the paperwork of the day. This includes reviewing and signing-off on my mid-level's notes and changes, performing administrative duties, and answering my personal and professional emails. In a typical week I see about 100 patients. Outside my office, I find that it is important to spend time with my family and friends and just enjoy the rewards of my hard work. I am very active in raising my three wonderful children and in teaching them the finer aspects of cooking and using power tools.
Q: How does using a team-based approach optimize your time and provide for the best for your patients?
Dr. Price: The team-based approach allows every member of the practice to work to their full potential. The team is led by me, as the physician in the office, though everyone in every position has a voice and gives input as to how the office can operate better and more efficiently. These (constructive) opinions are heard at regularly scheduled, weekly whole office meetings. Small changes are implemented on a PDSA (Plan-Do-Study-Act) cycle. Most staff members are cross-trained in an effort to be most efficient. Staff rotate through most positions, and on any given day they are responsible for different aspects of the visit. Most jobs overlap, adding a form of checks and balances to patient care in an effort to minimize errors. This cross-training of staff allows for smoother and seamless patient care before, during, and after the visit with fewer problems with billing and improved transition of care from tertiary care and specialty office visits.
Q: What is your most vivid memory from medical school?
Dr. Price: My most vivid memory from medical school was being blamed for someone's death. I was a third-year medical student doing my first internal medicine rotation. There was a comatose, non-intubated patient on the "ICU step-down" floor who was assigned to me and my intern. He was in renal failure and was being kept alive with dialysis while his family tried to decide how to proceed. As is commonly said, he was "actively dying." As such, he had labs drawn and checked twice daily. I remember that as a student, it was my responsibility to collect the labs for the intern to pass to his senior resident who then discussed them directly with the attending (the hospital was "old school" and medical students, and usually interns as well, didn't typically interact directly with attendings while in the day-to-day grind). One afternoon, the medical students were in a lecture and I didn't have an opportunity to collect the labs as I typically was doing. That afternoon, the patient's potassium reached a very high level and he passed away. After hearing that he died, I checked the most recent labs (drawn about two hours before his death) and discovered the elevated potassium and brought it directly to the attending physician's attention. She was very upset about the patient's death, and upon hearing me report the potassium, turned and said to me, "Well, because you didn't check the labs earlier, you killed him." Looking back, that one experience taught me more about responsibility, empathy, dedication and compassion than did the rest of my third year of medical school.
Q: What is the greatest challenge you have faced as a family physician?
Dr. Price: The greatest challenge I face as a family physician is the ongoing battle to hold others accountable for their actions as I do for my own. This includes subspecialty physicians, hospitals, pharmacies, payers (insurance companies, Medicare and Medicaid), patients and legislators. I address this through my daily interactions with all of these groups and through my advocacy efforts with the AAFP and the New York State Academy of Family Physicians.
Q: How have things changed since you entered the field?
Dr. Price: Since I began practicing medicine, a lot has changed. Electronic Medical Records (EMRs) are becoming more standard in most offices with which I interact, more medications are available now than ever before, medicines which we used and considered safe have been pulled from the market, and the influence, advertising and promotion of pharmaceuticals by their representatives have been shrinking. Also, government and health insurance companies have attempted to exact more control over costs by limiting tests and treatments avaiable to our patients. Despite all these changes and more, however, it's important to note that the physician-patient relationship, though it too has changed — or rather evolved — remains the backbone to the practice of medicine.
Q: What surprised you most as a new physician?
Dr. Price: What surprised me most about practicing as a new physician in a private practice was the lack of interactions with other family physicians outside of the office. When in residency, other physician comrades were always available to have scholarly and academic discussions or, more likely, to commiserate. People with like interests, lifestyle and experiences (professionally, anyway) were able to interact. Once I began private practice, I had to actively search out those interactions more than in the past.
Q: What do you love about your work?
Dr. Price: What I love and cherish most about my work is the interactions with my patients and my staff. I become part of their lives and they become part of mine. My greatest reward as a family physician is when family members of an existing patient decide, after experiencing how I care for their loved ones, to become patients themselves and also allow me to care for them.
Q: What would you tell an undecided medical student who is considering family medicine?
Dr. Price: I don't, and wouldn't, tell them anything specifically. I just show them all that I do through my actions, lifestyle and passion for my profession.
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Medical School & Residency
In Their Own Words: Family Physician Q&As
Dr. Marc Price