Tuesday, November 6, 2012

Reflections

This post isn't funny. But I mean every word.

November 6 is always a day of special meaning to me. My first secretary (Kate) called it Independence Day.

It's the anniversary of my going into solo practice. Which, after many years, is still one of the best decisions of my life.

As most of you know, I started out with Humungous Neurology, but after a few years I got sick of endless partner meetings (AKA sociopath's roundtable), bizarre fluctuations in my allegedly fixed salary that no one could explain, office politics, and the utter bullshit that seems to come with a large medical practice. Accountants showing me charts of dollars earned vs. square footage of office space used per patient drove me nuts.

Most of the other docs at Humungous Neurology, Inc., told me I wouldn't make it on my own. That I'd be back soon. That there was no place in modern medicine for a solo doc.

But I left anyway. It was a gutsy move. I had a 1 year old. Mrs. Grumpy was pregnant with twins, and couldn't work. I hadn't run a business since age 12, when I sold used golf balls (I fished them out of a lake on a nearby course, and sold them from a card table to passing golfers). My dad helped me form a corporation, and connected me with a friendly accountant he knew.

Kate (who was here before Mary) and Annie came with me from Humungous Neurology, Inc. But my first receptionist was - my mom.

To add another item to the list of terrific things Mom has done, she became my first receptionist when Kate had to go out of town that first week. She patiently answered the phones and made notes in a scheduling book, while I frantically tried to get the phones and computers to work properly. I didn't see a single office patient that week due to a phone system meltdown (it traumatized me so much that I've never changed it since).

Kate left me after 4 years to take a job closer to her home. I was afraid I'd never replace her. I spent a sleepless night at home, and the next morning she introduced me to Mary, who she'd met working for another doctor in the building. She'd found her own awesome replacement in only one day. And Mary is still here, and still totally awesome.

Annie and I have now been together for a total of 14 years, and I can't imagine doing this without her.

I have no regrets about solo practice. It was a self-taught crash course in business: insurance, payroll, withholding taxes, purchasing supplies, etc. It certainly isn't for everyone. But when it's all said and done, I prefer this more than any group. Nobody argues with me about my choice of computers, or EMG machine, or ISP, or whatever. Nobody makes me look at Powerpoint presentations on lobby decor. And nobody shows me charts of dollars earned per square foot per patient.

I'm writing this to say "thank you" to those who have made it possible for me to be here: Annie, Kate, Mary, my parents, and (of course) Mrs. Grumpy. It takes a hell of a lot of patience (and too many other qualities to list) to put up with me.

And, of course, the patients. Without whom I'd have no practice or blog.

Thank you all so very much.

IG

43 comments:

Anonymous said...

Congratulations! You are amazing. Your staff knows they're appreciated --it's always obvious in your posts. I'm happy that you braved the unknown & trusted your gut. We are all fortunate in your success!

S.M.O.D. said...

The sociopath's roundtable was an employment perk. Be honest - you miss it.

Where else could you dine on pizza that had the toppings picked off by one of the senior members of the practice (who only at toppings, leaving the slices with little grease-filled pockmarks)?

Old MD Girl said...

Thanks you SO MUCH for sharing this. It gives me hope that I will be able to find a niche in medicine that makes me happy. And you're right, nothing would be possible without all the people who support us in our endeavors.

PediNP said...

I'm an NP who left a small office, where I had a physician partner, to join a large teaching practice, where I'm still the only NP. My former MD partner was certifiable and made me crazy. We probably have a few of those in this large group, but I think the sheer size dilutes them out. As an NP, I don't have to participate in all of their meetings, which is a plus. I'd rather be part of this, then work solo with a crazy partner ever. You are lucky you can be in solo practice. But don't you miss having peers to commiserate with?

Grumpy, M.D. said...

PediNP - not at all. I have this blog for that!

ER's Mom said...

Congrats on finding your corner of the sky.

I am on my third practice. I hope to stay here for a long time. I tell people that finding a job after graduation is a lot like marrying someone after a first, blind date.

Anonymous said...

Good for you! It seems like it was a very wise decision, even in hindsight!

Anonymous said...

Congratulations! Here's to many more years of patient shenanigans.

Ami said...

My doctor has a solo practice for many of the same reasons you mentioned. I have been seeing her for 14 years now. Why? Because SHE HAS TIME TO LISTEN. A rare and valuable thing in a doctor.

I have a feeling you're that kind of doctor, too. We need MORE of them.

Charles said...

Congrats Doc. If this blog is any indication (and you're really not a yak herder) then it is clear you have a great practice.

Here's a toast of champagne:

"May the practice you have . . .

be the play that you love . . .

May you prosper to the degree . . .

That others envy thee . . ."

Cheers!

Liz said...

congratulations and happy anniversary. running a business isn't for the faint of heart, and it sounds as though you, your patients, and your family have all benefited from your hard work and good sense! good for you :-).

Packer said...

From one solo practioner (with tears in his eyes, for I heard and lived every word of your story) to another--Congaratulations---it takes a set to set sail from safe shores.

RebeccaJ said...

What a nice tribute to those who have helped you along the way. I love your blog, it's currently my favorite. I am neither witty nor quick with a joke, but I appreciate your humor. Congratulations on your anniversary.

Anonymous said...

Awesome.

jimbo26 said...

Behind every great man , there is a brilliant woman . ;-)

bobbie said...

What a lovely post! Many congratulations ~

Anonymous said...

You have come far, young Jedi.
Remember always- to use the farce.

Anonymous said...

Congratulations! What a wonderful post from a wonderful doc!

Jono said...

If I ever need a neurologist I will drive the 900 or so miles to see you.

Wendy said...

Wow, happy independence day! Was Kate as special as Mary? Must have been weird and wonderfull that you were without awesome secretary for just one day.

Anonymous said...

No, Thank you Dr. grumpy. Thank you for (almost) 9 years of the best working years of my life. You make coming to work not dreadful. Coming from a big corporation myself, I can certainly agree that I wouldn't want it any other way but solo. Your decision to shoot for the stars and create a solo practice has been wonderful in more than one way. You're patients adore you, they trust you, they appreciate you, and besides, Annie, you, and I make a great team. You treat us exceptionally well, and your patients too. You are truly one of a kind and irreplaceable. So Thank you Dr. Grumpy, for the opportunity to work for you and be apart of your Dream practice! <3 Mary

Grumpy, M.D. said...

(Blush)

Ms. Donna said...

Congrats! Your solo practice is something I bet your pts enjoy. I have been to a "Humongous" practice a time or two and felt like a cog in the medical machine.

Being sick is no fun, and that just makes it worse.

Best to you and ll the people who make the gerbil wheel turn!

Moose said...

Aw, man, there's no way I can follow Mary. GEEZ!

But, really, there's no way you could post the things you do without the support of all the people who support you, both personally and professionally. They're part of the solution, not the problem. Or the precipitate.

I used to see a doctor who was originally with a larger practice. One day when I was very sick in the hospital, the senior doctor in the practice came in instead of my doctor. Instead of addressing my problems, my healing, my at-the-moment serious health issues, he chose to start berating me for being overweight. It went on for about 5 minutes before I finally yelled [to be heard over him, he wouldn't let me get in a word edgewise], "WOULD YOU PLEASE DEAL WITH MY ACTUAL CURRENT ISSUE??" He promptly left in a huff, mad that I wouldn't "take his advice." I told my doctor about it next time I saw her, and you could see her teeth set on edge.

A month later my doctor told me she was leaving the big practice and starting her own practice. When I asked why, she said, "Remember what happened to you in the hospital? It's too much of that kind of crap."

I've heard of this problem as "the bike shed problem". You get so involved in what color the bike shed should be painted that you ignore immediate issues like not having enough materials or the right building permit. The smart people stop and look at the whole picture. The nutters pick on the little details that don't have to be dealt with right now.

May your bike sheds always be constructed with people who worry about the correct details at the correct times.

Anonymous said...

It's awesome that you respect and honour your staff. My last employer let me go after 21 years of very loyal service (giving me only 10 minutes to clean out my desk and leave the building) and not even allowing me to say goodbye to coworkers or clients.
(PS ... I won the lawsuit that followed)

merinz said...

Well done. It sure was the right decision.

And lovely to read your comments too, Mary. We can all tell from his comments that Mr Grumpy is a wonderful person to work for.

Mari-Ann said...

That actually brought tears to my eyes. You are a good man to recognize, appreciate and thank all of those who have supported you and helped you along the way. And thank YOU for sharing your life with us...I really consider you the best doctor I know (and I know a lot of them!)

Anonymous said...

Fabulous post. It's so nice to hear that someone has found their niche in the working world and has wonderful people to share it with. Gives me hope.

gin4407 said...

My husband came home one evening and told me he quit his job working for a large engineering firm. That night we celebrated! Friends and family called to congratulate him! He started his own engineering company and hasn't looked back once. Congratulations, Dr. G!

gin4407 said...

My husband came home one evening and told me he quit his job working for a large engineering firm. That night we celebrated! Friends and family called to congratulate him! He started his own engineering company and hasn't looked back once. Congratulations, Dr. G!

bobbie said...

A beautiful note from Mary ~
we love you too, girl!!

Heather Piper said...

Best thing ever working for yourself. Keep up the good work!

Anonymous said...

Sigh...big shock that moose takes the opportunity (yet again) to hijack your lovely post and make it all about "moose".

At any rate, Happy Independence Day! May you, Mary, Annie, and Ed have many more happy and successful years together! Loved reading this entry and Mary's reply :)

gloria p said...

Congratulations on having made a good decision all those years ago. Having followed your blog for quite a while, I have seen you as a terrific doctor, husband, father, and boss. Now if you could only give up the Diet Coke and convince #1 son he doesn't need all that hair goop....

Anonymous said...

Wow. Gorgeous roses. Your whole office deserves a bloomin' rose garden in November. Congratulations! When some one is truly happy, it's contagious. Thanks, for your dedication to your oath, Dr. G. and integrity.

brent said...

Dr. Grumpy-remember to shoot for the stars. But, if you get the tragectory wrong, you will always have a very spectacular-albiet fiery and brief-re-entry.

Glad you got it right!

heterodyne said...

Awwwwwwwwwwwwwwwwwwwwwwwww. So nice to read this. Imagine a cloud of hearts and roses (in the bestlooking sense of the words).
It's very uplifting to hear of such places with all the dreary incompetence and focus on wrong issues I see elsewhere. Thumbs up and all the best for the next 30 or so years ;)

Anonymous said...

Dr. G, it's certainly nice of you to share your success with Annie, Mary, Kate and mom, but have you not been listening? YOU DIDN'T BUILD GRUMPY NEURO! It was the government that gave all this oppertunity to you and the staff - not you building it. Wow, the never to take credit.

Everyone see's how crazy my statement is when written like that. Why does it not sound just as crazy when our president [for another long, long, long four years] says it? Just yet another story of how it's people like Dr. Grumpy that make this world tick. Good thing you did all of this years ago. I'm extreemly fearful you or anyone else will ever be able to do it again in the future, Obama Care and all.

CONGRATS!!!!! I'd become your patient in a heartbeat - or a blod clot as it were.

Just Me said...

Dr Grumpy & Mary - any recommendations for front desk staff for someone in Oregon. On 3rd person this year. Killing me.

The Evil Receptionist said...

Congrats on your anniversary!! I'm so thankful that you let your staff know how much you appreciate them!

I still think, however, Mary needs a raise. ;)

King J's Queen said...

Sounds like you have a wonderful team there and I always enjoy reading the stories. Personally, I seek out small practices, rather than the larger ones, since I am the primary caregiver for both my parents and I have a child at home. The doctors in smaller or solo practices seem to know their patients better. (Funny, the only big practices we still visit are orthopaedic and neurology ones. Ha!)

Congratulations to you and your team for 14 years!

pharmacy chick said...

Great post Grumpy! congrats! you have done a great job!

Hal Dall, MD said...

Congrats, DrG!

I have been solo for 25 years, and cannot imagine being otherwise. (I once had a partner for a 7 month disaster.)

That front desk person is the key, not only to a successful practice, but also to sanity! Or the reverse!

 
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