THE LAST WORD
Keeping Your Practice Going When You Can't
A physician battling illness has the added worry of who will care for his patients.
Fam Pract Manag. 2017 May-June;24(3):40.
Author disclosure: no relevant financial affiliations disclosed.
I am a 70-year-old family physician who had no plans of retiring. Perhaps it's because I'm in solo practice and love it. I have plenty of free time (I only work half time as it is). I've always felt that my medical school admission was a gift I had to pay forward as long as possible. And my rural town is experiencing a severe doctor shortage, so who would fill the void? When my patients would ask me when I was going to retire, I would tell them, facetiously, “When I can't remember your name or diagnosis.”
Then I got cancer.
I was shocked to get my diagnosis. (See “How a Doctor Acting as His Primary Care Physician, With a Little Luck, Tracked Down His Own Cancer,” FPM, May/June 2017.) In 40 years, I hadn't missed more than a week of work from illness. I was in unchartered territory, not knowing what my treatment would be, how long it would last, or whether I would physically and mentally be able to work. Three things I knew for sure: I needed help, I wouldn't trust my patients to anyone I didn't know, and I wanted doctors.
My rural Northern California community has an aging medical workforce. Most of us came here in the 1970s when we were fresh out of training and cared more about lifestyle than money. Curiously, not many came after us, and we all grew old together. Several of my colleagues in primary care have retired, while others now work as hospitalists out of town and have relaxed schedules. So I sent off emails to my colleagues Buz and Richard: “Can we talk?”
Both were willing to help, essentially providing coverage every other week for three to four mornings. In addition, Dalia, my office manager and only employee, and I decided to pare down the practice and see only patients with acute and chronic care needs, eliminating a lot of the medicolegal work we do.
Both Buz and Richard, it turns out, are covered under my malpractice policy as locums. We agreed on an hourly wage based on what another doctor in the area has paid for a similar service, and I am hopeful that billings will cover overhead. A young doctor in our community has expressed interest in working in our office just to see how an independent practice is run, and a resident in a nearby
Editor's note: Read more of Dr. Brown's story in “How a Doctor Acting as His Primary Care Physician, With a Little Luck, Tracked Down His Own Cancer,” FPM, May/June 2017, and “The Key to Getting Through Chemo,” FPM, July/August 2017.
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