Experimentation and reciprocity
The first three weeks of independent practice
Hello all,
I’m here with a few reflections on my first weeks of independent practice. For context, I have onboarded my first patient (aka #1 Patient / Patient Zero). The main challenge I dealt with this month: repeatedly quelling the urge to actively recruit more patients before I am ready.
Over and over I’ve had to remind myself that I’ve only been open for a couple of weeks and to re-focus on the long-term vision. I intend to build my practice over 10 years, not 10 days. We so often get caught in cultures and systems that don’t give us the time and emotional space to do things at their natural pace. Over time, we internalize the unnatural pace, which leads to feelings of false urgency and heightened anxiety… a self-perpetuating cascade of rush and un-health. For me this looks like responding to e-mails right out of bed, forgetting to eat breakfast and lunch, and a mind that flits in an undisciplined and unsettling manner.
Staying cognizant of these tendencies, being patient, and practicing my return to ground level over and over again has allowed me to pay attention and focus on experimenting with my first patient. I’ve emphasized to him that everything is on the table for redesign, including the cadence and modes of our communication. I’m doing my best to come at this with a beginner’s mind. All of the environments and structures (including time structures) that we associate with medical practice or “going to the doctor” were created for specific purposes, circumstances, and contexts. This was the topic of one of my research papers published in the Annals of Internal Medicine (full PDF attached below if interested).
It is now my job to determine how I want to design for this particular ecosystem (with its ever-evolving constraints). What structures and environments will support the sacred core: a trusting relationship between physician and patient?
Growing slowly has also given me time and space to (1) revisit and refine my onboarding process and compliance policies, (2) contribute thought and labor to our home building project, and (3) continue naturally developing relationships in my community both locally and worldwide through Canyon Oak.
Making friends and embedding one’s practice into a nurturing community is part of “the job,” too, especially when you realize that “the job” is to build a rich life and practice medicine for decades to come. It’s useful from a business perspective for people to know you (if you’re kind and respectful), but I’ve also come to believe that it’s the reciprocity from these relationships that will allow me to practice medicine healthily for decades to come.
On reciprocity
A few reciprocity examples from this month:
Physician-patient:
Going out on my own 3-mile walk after hearing about my patient’s 3.5-mile walk
My patient helping me confirm documentation retention policies
My patient sending me memes (see below) and inadvertently reminding me to have fun and enjoy the process
Communal:
Lunchtime text messages with another local small business owner (Winnie Superette) helping us both remember to eat lunch and tend to our bodies in the midst of endless administrative tasks
Inspirational coffee meetings with a renowned local trainer (Form is Function) giving me ideas for my own approach, onboarding procedures, and patient agreements
Next steps
Re-review compliance documentation and questions with my healthcare lawyer
Re-review bookkeeping and tax strategy with a small business tax advisor
Continue preparing for my first home visit (I’ve been neck deep deciding what goes into the most basic version of my doctor’s bag)
My doctor’s bag! Ain’t she purty? Share my practice website with a widening circle
Recruit a “Patient Zero” (and technically Patient #2) for my telemedicine-only healthcare professional practice. If you’re a healthcare professional in California, interested in attentive/pro-active/forward-thinking primary care, and interested in helping me design/build my practice, let me know. You can book a free consultation appointment here: https://michelle-md.com/contact/.
Cheers to taking care of one another,
Michelle