'Why I'm Loving Private Practice'

I was a physician employee, many times for many hospitals and clinics. I'd stay a year or two, but eventually I'd quit. Then, in 2005, I opened an ideal clinic designed by my patients. Eight years later, I still love private practice. Why? I'm finally practicing medicine the way I had always imagined.

When I decided to open a private practice, I was determined to do things differently. I needed to know what my patients really wanted from me. So I led a series of town hall meetings where I invited my community to design an ideal medical clinic. I collected 100 pages of written testimony, adopted 90 percent of the feedback, and opened one month later. Now my job description is written by patients, not administrators. I'm finally the doctor my patients had always imagined.

I work collaboratively with my patients in a neighborhood family medicine clinic where nobody is turned away for lack of money. It is ideal. There are so many things I love about private practice. Here are a few:

• Autonomy. No more committee meetings. If I want to change an office policy, I just do it. I don't ask permission for time off. I just take off. Fortunately, I rarely feel the need for a vacation since I work a humane, part-time schedule (20 hours per week, including administrative work). By the way, I'm in control of my schedule. I never double-book. I'm never rushed or frazzled.

• Disintermediation. By "removing the middle men" and no-value-added intermediaries, I now have more direct relationships with my patients. They requested a simplified, small office with less staff running around. So now I'm a solo doc with no staff. I don't miss the layers of bureaucracy and administration. Nor do my 500 patients who get uninterrupted 30-minute to 60-minute appointments. I do accept most insurance plans; the ones that don't require hoop jumping through a gazillion unfunded administrative mandates.

• Finances. Because I'm no longer supporting a bloated bureaucracy that does not support me or my patients, I have extremely low overhead. As a result, I'm taking home three times as much income from each patient visit than I had taken home per visit in my high-overhead employed positions. Yep. I make more money seeing fewer patients and I do this without charging patients any extra fees.

• Authenticity.  I dress casual, not corporate. I'm usually in Levis and clogs at work; so no white-coat hypertension. My patients appreciate that I dress like a real person. One woman exclaimed, "It's so refreshing to meet a doctor who is a real person with a real personality." I like being me. Why hide from my patients? I've never practiced professional distance. I believe professional closeness is most therapeutic.

• Fun. I have a gift basket in the exam room with prizes for patients who have lost weight, quit smoking, or achieved other health goals. Patients also receive gifts if they bicycle or walk to the office. I host random "Patient Appreciation Days" with balloons and dark-chocolate treats. I even throw clinic holiday parties - all patients are invited!

• Inspiration. What I love most about my practice is that I've stopped complaining about medicine. After all, if doctors are victims, patients learn to be victims. If doctors are discouraged, patients learn to be discouraged. If we want happy, healthy patients, why not start by filling our clinics with happy, healthy doctors? By enjoying private practice, I've inspired my colleagues to start enjoying their own careers again. Some have opened ideal clinics. Some docs have told me that I've saved more than their careers - I've saved their lives.

Pamela Wible, MD, is a family physician in Eugene, Ore. Wible also hosts biannual retreats to prevent physician burnout, depression, and suicide through IdealMedicalCare.org. Do you still love private practice? Tell us at editor@physicianspractice.com. Unless you say otherwise, we'll assume that we're free to publish your comments in upcoming issues of Physicians Practice, in print and online.

This article originally appeared in the July-August 2013 issue of Physicians Practice.