…before he left his former practice, he was delivering a standard of care which troubled him. He was losing his love for medicine and patients.

As I asked SP about his typical day, he told me that he physically saw 6-8 patients each day. He spent at least as much time on the phone or answering email as physically seeing patients. At least once each week he makes home visits. He often calls his patients preemptively.

Because of his intense outpatient work, his admission rate is very low. He needs less consultants and orders fewer high ticker imaging studies.

This movement continues to grow. It grows because patients are willing to pay for service. Unfortunately, the Medicare reimbursement system drives what other insurers pay. This illogical, bureaucratic system is destroying outpatient internal medicine. Retainer medicine and cash based practice may save these practices.

Amen brother.