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Smart Doctors Office: Back To The Future

ROCHESTER, N.Y. (Ivanhoe Newswire) -- This year, the typical American family of four with health insurance will spend almost $3,000 out-of-pocket on healthcare, and costs keep going up. Though you're spending more money on medical expenses, you're probably spending less time with the doctor. As practices get bigger, doctors have less time for each patient. Now, new research on doctor's offices and their efficiency finds that bigger may not mean better.

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Family medicine physician Elissa Sanchez-Speach, M.D., of Rochester, N.Y., practices medicine the old fashioned way: one patient at a time.

"I am the primary person; the only person really who is getting to know the patients and manage their care," Dr. Sanchez-Speach told Ivanhoe.

In her office, she's the receptionist, doctor, nurse, bill payer and office manager, and still spends 30 minutes with each patient.

"I love it," Dr. Sanchez-Speach said. "I wouldn't want to do it any other way at this point."

Operations researcher at the University of Rochester, Edieal Pinker, Ph.D., says a small office like this can be as profitable as a high volume practice with more employees.

"Introducing all of the support staff actually introduces a lot of inefficiency into the work process," Dr. Pinker explained.

Here's how the model works: a primary care physician alone can see one patient per hour. Add a nurse and the doctor can see two patients per hour. But if you add an additional two nurse aides and an office manager, the physician can still only see two patients an hour.

"Adding more staff doesn't actually add more value financially to the physician because everything you can do in terms of seeing patients you lose in terms of paying more salaries," Pinker said.

For Dr. Sanchez-Speech's patients, smaller is better.

"Since she does everything and communicates with you directly," Dr. Sanchez-Speech's patient Josh said. "It's a lot more personal."

It's an old fashioned approach that could have new value as health care reinvents itself in the future.

This research only applies to primary care medical practices. Researchers say that in specialty practices, extra employees can create greater efficiency, and more profits. Meanwhile, there's a growing movement toward small family medicine practices like Dr. Sanchez-Speech's.

The Institute for Operations Research and the Management Sciences and the Human Factors and Ergonomics Societ contributed to the information contained in the TV portion of this report.

Click here to Go Inside This Science or contact:

Edieal Pinker
Visiting Associate Professor of Operations Management

edieal.pinker@yale.edu

Institute for Operations Research and the Management Sciences
Barry List
(443) 757-3560
http://www.informs.org

barry.list@informs.org

Lois Smith
Human Factors and Ergonomics Society
Santa Monica, CA 90406
(310) 394-1811
http://www.hfes.org

lois@hfes.org


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