Why Physicians Should Practice Medicine in South Carolina

Narayanachar Murali came to South Carolina because he felt the state had a need for his skills following specialty training. Murali, who is board certified in internal medicine and gastroenterology, runs a solo gastroenterology practice in Orangeburg, S.C.

Murali recently told Physicians Practice that while he eschews EHRs, he still uses paper charts, he does embrace technology.

"I have a highly digitized, connected office. If you look at my website you'll get an idea of the complexity of my practice. And, how well I practice, actually. Because I finish my work in time, and my patients have their records - they have access to their records all the time," said Murali, who provides patients digital copies of their records on a USB key.

For you, what is the best part of practicing medicine in the state of South Carolina?

When I finished my fellowship there was a need for my skills here, and I came here. I like the place, and I still enjoy it.

What, if anything, would you change about the climate for physicians in South Carolina?

Nothing about South Carolina, [but, I don't like] what's going on in the medical insurance industry, that's universal, it's not unique to South Carolina.

In my case, I have remained solo for that reason. I'm finding it increasingly difficult; the repercussions [from low reimbursements], most of the doctors have been bought over by hospitals. A patient goes to that office for a visit or a consultation - they end up paying the administrative charges which can be as much as two times the visit charge.

And there are fewer doctors who want to see sick people, they don't want to see anybody, it has to do with [reimbursement] … we end up sending these people to a bigger hospital outside the city; I end up sending them to Charleston or Columbia [because] no one wants to see complex patients locally. We don't have physicians, they all are extenders. When you have a serious problem you can't use extenders.

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