Dr. Jean Benson was a busy, yet content, family practitioner who, with another physician as partner, managed a bustling practice north of Boston. Seeing patients from “newborn to tomb,” the practice had a philosophical model of treating the whole patient. They wanted to spend time with patients to hear why medical issues may have arisen to cause their symptoms, instead of just treating their symptoms.
“A patient who presents with high blood pressure and anxiety can be treated with high blood pressure medicine and anti-anxiety drugs. However, if that same patient is suffering debilitating depression due to the loss of a loved one, simply prescribing drugs may not be enough. I need to talk to them to hear what the best solution for them may be, both long-term and short,” Dr. Benson said.
This focus on the whole patient worked well until her practice partner fell ill, and was no longer able to maintain a full caseload. A drop in billings soon followed, as Dr. Benson was not able to see her patients and those of her partner. In addition, falling government and private insurance rates dramatically reduced reimbursements. Unable to pay the rent and other expenses, she turned to a managed care company to help with operations and staffing. The company took over her practice and hired Dr. Benson to see patients and oversee staff.
“I stayed on as medical director of my practice in order to preserve our function as best as possible. However, the managed care model eventually pulled me away from my patients in many ways, including putting layers of nonprofessional staff members between me and my patients. Both the patients and I were frustrated by their inability to reach me for the answers to their questions and, eventually, I thought the interference of these essentially untrained individuals created a problem for both me and my patients.”
“Under the managed care model, I had 15 minutes to see a patient, diagnose, and complete their charts and other paperwork. That was on a normal day. When patients wanted to double-book appointment times due to legitimate reasons, it meant I had 7 and a half minutes per patient. I wasn't treating their problems, just their symptoms.”
Dr. Benson knew it was time to try something else and began working ER shifts on her days off to get as much experience as possible. Once she left the managed care company, she worked locum tenens ER assignments and asserts that she is happy with them.
“I love the variety ER offers, both in the cases patients present and how the cases expand my knowledge and keep me sharp. ER docs seem to be a happier group than most, since they are able to care for critical patients, and see the results of their efforts immediately. One of the ways I bring my family practice background to my ED practice is in education. Although the ED visit is usually a single event, I often find it appropriate to sit down and speak with my patients in a positive fashion about their general medical condition, how their medications work, and what they may anticipate in the future. Occasionally this really pays off when the patient is able to better understand how their decisions affect their well being.”
Dr. Benson is one of many doctors who re-discovered medicine and their love for it through locum tenens assignments. Do you or someone you know also have a story like Dr. Benson’s? Please share in the comments below.