If you have kids over the age of 8 (and probably even if you don’t), you have seen some or all of Marvel’s Avengers movies. At the beginning of the first Avenger’s movie Agent Phil Coulson explains to Captain America why he uses the American flag as the motif of the new uniforms saying,
“With everything that’s happening…people just might need ‘a little old fashioned'.“
I feel the same way.
My peers often tell me that I’m old-fashioned and while I suspect the label is meant to be a bit of an insult to my age, experience and approach to my practice, it is a badge of honor that I wear proudly.
I believe that if more doctors today practiced medicine the old-fashioned way, both their patients and practice would get better.”
Never bypass or gloss over doing a complete medical history or physical examination.
The new way of practicing medicine has made the skilled clinical diagnostician a vanishing species. Physicians now rely almost solely on testing and technology to form opinions – a dangerous approach in any specialty – but an impossibility in psychiatry. In the name of efficiency and keeping costs down, the medical history process has suffered the most from shortcuts. This approach also takes the personalization out of medicine, all but eliminating the individuality of patient care.
Always work as long and as hard as it takes to ensure the wellness of their patients.
I always take a full 60 minutes to complete an initial appointment/evaluation (with subsequent visits adjusted based on clinical need) while doctors in other settings will spend no more than 20 minutes on a visit, and often attempt to keep their appointments to roughly 10 minutes or less.In curtailing the time spent with patients, providers are decreasing their own effectiveness. By contrast, the “hands-on” approach ensures that I treat the patient, not the disease. My small practice benefits from a personalized style of care and allows me to practice the way I want – which is doing whatever I need to help people feel better.
Thrive on hands-on interaction.
Psychiatrists who do not invest in an adequate medical history, take the time to develop a sound management plan, and communicate thoroughly with the patient to fully engage them in the healing process are missing out on the best part of the doctor-patient relationship!When you work closely with patients and empower them, they are going to make better choices. Maybe I see fewer patients a day, making it a little tougher to get an appointment on the day and time you want, but in seeing fewer patients in a day, outcomes are better for patients.
Value confidentiality over technology.
Digital records are required for inclusion in government-based reimbursement programs, but they are expensive to purchase (adding overhead costs for patients to bear) and decrease productivity (leaving less time for the physician to spend with patients).I have always kept patient records on paper and out of the cloud – there is no chance of anyone “hacking the system” and getting your information. And because we are a private pay practice, your insurance or your employer NEVER has access to your treatment data.
Understand that big is not always better.
There are multiple studies that affirm what I have learned over the years: the uber-large practices, with their care management teams and sophisticated clinical information systems, do not produce better care for their patients. The benefits of spending more time with patients extends beyond feeling good about your doctor: practices with 1 or 2 physicians have been shown to have lower costs of care, lower hospital readmission rates and fewer preventable emergency hospital admissions.
For all these reasons and more,
I am proud to be a little old-fashioned.