What would you tell the elderly mom of your disabled alcoholic patient in his 30s when she is buying him alcohol - stop enabling! It's important that you stop enabling patients to take advantage of YOU. No person - no doctor - can sustain being at the beck and call of anyone, never mind a panel of patients.
In Direct Care, YOU are in control of YOUR practice. A huge benefit of the model of care is that you schedule how it works for you and you determine how you want to be contacted and seen. Patients aren't expecting medication delivered to their door; most don't want unneeded tests once you explain the data; all they really care about is access to you.
If you offer a never-ending, never-say-no, style of practice - patients believe that is what they should expect. If you're at your daughter's basketball game, and they're used to you dropping everything to do a home visit - then they expect you to drop everything to do a home visit. Most of us cannot sustain such never-ending, no-boundaries care. And we DON'T have to. If your practice can't make it because you cannot sustain what you think you have to promise to keep your patients, then your patients will soon be out one very good doctor. Most of us are in medicine because we are altruistic about caring for others and it's easier than most to fall into the trap of giving too much of ourselves.
First step to rebooting the success of your over-promised practice - decide what kind of practice do YOU want to have? If you love home visits, you have to build time for it within the work hours you prefer. If you want to see newborns at the hospital or at home, make sure you have buffers in your schedule where you can make that happen. Learning to say no to things that are not your priorities is one of the most important boundary-setting exercises.
If you find yourself knee-deep in enabling, I suggest taking that step back to look at what you are doing that you LOVE and what you are doing that is sucking the energy out of you. Make two lists and be honest with yourself! Figure out how to remove things from the "bad" list. If you find that you wish you were seeing more sports medicine for your own patients rather than referring that out and you realize you don't love doing IUDs - change the menu of services you offer. If you find you can't fit in home visits for elderly patients, charge an amount fitting to homebound care so that you can see fewer patients but at the level that they and you need.
If you find yourself lost in determining how to unburden your practice, I am happy to help! Email me at firstname.lastname@example.org and get on my mailing list to be updated about new blogs and calculators that can be your tools to success.
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I am a Family Physician, wife to a doc, and mother of three with a mission to convince you as a doctor that you are worth more than the system is giving you and that you are already well-equipped to make a big change without adding more burdens! My passion is helping existing or start up Direct Care practices learn to troubleshoot, streamline, and simplify.