A doctor without an office

A new style for the iPod generation of physicians:

Let us be the latest but certainly not the last blog to spill a few pixels over Jay Parkinson, M.D., of Brooklyn. The good doctor and scarily accomplished photographer . . . has an offer to take care of you for $500 a year. And most of the time, you’ll be meeting online.
Parkinson, 31 and freshly licensed, has got no office, though he’s looking into renting a room. You’ll get two face-to-face visits a year (at your apartment, office or other mutually convenient place) and unlimited “e-visits,” his word not ours, for help with your health. Those e-visits could be IM chats, emails, or Web video sessions.

Here’s his website.

Comments

Anonymous
It would be interesting to see what he’s up to in a year.
It’s a not bad idea, but I suspect his business won’t end up as originally envisioned. Hopefully the e-consults can include digital images .
Anonymous
He needs to have a partner to take call for vacations, cme’s,or family activity. If there are more patients applying, then get rid of the hypochondriacs and those who require high maintenance.
Anonymous
US Congressman Paul Broun, MD of Georgia had a housecalls only practice.
Anonymous
In my state, he can just tell them that he will not be available at the that time and to call someone else or go to the ER. (I just heard a collective sigh from ER docs everywhere). He doesn’t have to be a slave to it. And the low overhead will allow him to take off without shelling out a fortune.
If he chooses to cover the practice 24/7, I imagine that he would have no trouble getting a regular office based doc to cover–especially if he refers the patients over 40 that call him to them. They would be getting overflow from his practice for very little work.
Happyman
In my experience those who pay out of pocket (as opposed to those with medicare) are going to be much higher maintenance, calling in the middle of the night for the sniffles, etc.
However, since medicare pays much better for housecalls than office visits, a housecall practice focusing on the elderly is a good business model (I do this part-time). This is still stressful at times, dealing with concerned families & aides, and as with an office practice, there is lots of unreimbursed work, although the overhead is potentially very low compared to office practice.
Anonymous
The 24/7 coverage is an insurance issue. If he’s not taking insurance, there’s no reason why he can’t leave a message to go the the nearest ER.
There are independent nurse practitioner clinics in my town. That’s what they do. Free-standing urgent care clinics. That’s what they do. The retail clinics you hear so much about these days. That’s what they do. Why are the rules different for a private physician in independent practice?
Anonymous
The old 24/7 thing is an insurnace scam that docs have fallen for.
Some guy gets a wart removed once and your’re on the hook for his every need at every hour regardless of whether you ever see a single dime from him or his insurer again. Has any other profession fallen for this con job?
Anonymous
It is something we do to each other. Some medical boards require it. A local physician complained to my board when I stoped taking call. I was ahead of him. I had already checked and found that they considered it a contractural issue for outpatient practices. If you tell people it is office hours only then that is fine by them. Obviously with patients in a hospital, you would have abandonment (and staff rules) issues preventing that. Also, the fact that they don’t require it doesn’t mean you wouldn’t have an obligation under common law when treating an acute illness. I therefore, even though I “don’t take call”, still check on or give my number to patients who are having an acute episode of illness. It is the right thing to do and makes me feel better. Only one person abused that access in several years.
Jules
This is a pretty interesting idea. I’m curious if it would be good for someone with chronic issues.
Jay
Thanks for the post Kevin. Always nice to read interesting discussion. It’s a bit like getting free consultations from those who have been in the trenches much longer than me. I’ll keep everyone posted about the progress of this practice on my blog:
http://www.jayparkinsonmd.com/blog
Thanks again.

A doctor without an office

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