Micropractice
Patients at his "micropractice" can call or email to get appointments the same day. Visits last 30 minutes. Dr. [Gordon Moore] can be reached day or night on his cellphone. To refill a prescription, he walks "zero feet," he says, and taps a few keys on his laptop. "I was able to build a Norman Rockwell practice with a 21st-century information-technology backbone," he says.
The doctors' compensation plan changed from a guaranteed salary to a share of the practice's revenue, making it less secure. "It seems that all of the conversations in our office were about money," Dr. Moore later wrote in a medical magazine, Family Practice Management. "A good doctor, it seemed, was one with high visit volume."
Once or twice a year, Dr. Moore asks his patients to complete a free Web survey called "How's Your Health." Developed by John Wasson of Dartmouth Medical School, the 10-minute survey is a series of carefully formulated multiple-choice questions about the patients' symptoms, medications, diet, past tests, emotional issues and habits, such as smoking and drinking. The survey evaluates the answers and converts them into a one-page snapshot of the patient's health. It also suggests links to relevant health Web sites, and can tell the patient how to track blood pressure, cholesterol or weight.
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ROCHESTER, N.Y. -- After eight years as a staff doctor at a hospital-owned medical practice, Gordon Moore began to really dislike his job.
To increase revenue, the hospital pressured him to see more than 30 patients a day, usually for 15 minutes each. Many patients couldn't get appointments for weeks. Dr. Moore determined it took 19 separate actions and 253 feet of corridor-walking to order a prescription refill. He says he was so rushed he often failed to...
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