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Questions for Dr. Stern

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57.  I stumbled onto your website in my frustrated search for an improved practice style, and am interested in what you might have to offer.I own my own family practice (and the building)  We have been in practice in OR (pop 10,000 with a few smaller towns in the area, county population around 30,000) for about 18 years and are financially successful.  Besides me there is a physicians' assistant and a nurse-practitioner/nurse-midwife.The problem is the HOSPITAL CALL!  Increasingly, this is beyond burdensome and creates severe stresses among the medical staff (who will do what and when?).  The hospital will not do anything to help out so long as they can force the staff to do it.  And around here, you more or less have to maintain staff privileges in order to practice. The urgent care doctors I have known do not have any hospital call, they treat every encounter as a "new patient visit" even if they have seen that patient dozens of times, and they don't seem to have any ongoing responsibility for people once they leave the office.  I would like to know how they can get away with that, and whether I can convert my office into an Urgent Care Center. What, exactly, are the conditions required for a successful Urgent Care Center? I am serious, and I hope you will respond.  I feel like Family Practice is leading itself (as a profession) into indentured servitude.  This Urgent Care model might be just the ticket to separation from the hospital system.

First: converting to an urgent care may eliminate the night and weekend coverage issues.  However, be careful, some MCO’s require you to maintain hospital privileges, and hospitals may require you to take ER call in order to stay on staff. Switching to an urgent care center can be done quite effectively and efficiently in an existing primary care practice.  You will need to make a gradual transition, and many of your patients will continue to come see you, even though you will let them know that they will need to be admitted to a specialist if they are admitted to the hospital and you are not available for emergencies at night.

 

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David Stern, MD, CPC
CEO, Practice Velocity
Partner, Physicians Immediate Care
Board Member, Urgent Care      Association of America

Dr. Stern helped design the patent-pending Practice Velocity template (PiVoT) that is now used in over 240 urgent care centers. He is board certified in internal medicine and served as Chief Resident in Internal Medicine at Pennsylvania State University. Dr. Stern received his medical degree from Jefferson Medical College of Thomas Jefferson University after completing undergraduate studies at Houghton College in Houghton, NY. Dr. Stern serves on the Board of Directors of the Urgent Care Association of America (UCAOA). A Certified Professional Coder, Dr. Stern writes articles and presents at numerous national and regional conferences on topics, including medical charting, emr, medical coding and medical practice management. With additional partners of John Koehler, MD (CEO) and Terry Buzzard, MD (Regional Medical Director), they operate the urgent care consulting firm of National Med Network and the ten clinics (in Illinois and Oklahoma) of Physicians Immediate Care.

 

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