Happiness-Based Musculoskeletal Medicine The Ideal Micropractice 101 2015 AAPM&R National Conference Justin Berthold, DO – PM&R

Who am I? Justin Berthold, D.O. Physical Medicine & Rehabilitation Physician Focus on restoring function and quality of life Treat the whole person and not just the injury Rehabilitation Physicians of Pittsburgh – Founder The Children’s Institute of Pittsburgh – Medical Director of PM&R LECOM at Seton Hill – OMT Faculty

Ok, but Who am I?

How this all started…

How this all started… Gordon Moore, MD

Moore’s 4 Pillars of Success ACCESS Patients have unlimited access to the care and information they need, when they need it. INTERACTION Interaction between the patient and care team is deep and personal. The care team has “memory” of the patient. RELIABILITY The system exhibits high reliability in that it provides all and only the care known to be effective. VITALITY The practice has vitality: happy employees, a spirit of innovation and financial viability.

A Wise Mentor’s 3 Pillars of Success AVAILABILITY AFFABILITY ABILITY

Keep it Simple What is an Ideal Micropractice? Why do such a thing? How to take the leap? Pearls and pitfalls Year 1 results

http://www.aafp.org/fpm/2007/0900/p20.pdf

What is an Ideal Micropractice? Key Principles High-quality, patient-centered, collaborative care Unfettered access and continuity Extreme efficiency

Let’s Keep it Simple What is an Ideal Micropractice? Why do such a thing? How to take the leap? Pearls and pitfalls Year 1 results

Why Do Such a Thing? Why not? Unpredictable healthcare climate Patients deserve the best of me Will learn much more if I do this Set up for a solid plan B

Physician Burnout Burnout is commonly defined as loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment.

Physician Burnout A national survey published in the Archives of Internal Medicine in 2012 reported that US physicians suffer more burnout than other American workers.[1] This year, in the Medscape Physician Lifestyle Report, 46% of all physicians responded that they had burnout, which is a substantial increase since the Medscape 2013 Lifestyle Report, in which burnout was reported in slightly under 40% of respondents.

Physician Burnout In this year's survey, the lowest happiness scores at work belonged to radiologists (4.46) and, as expected, those on the front line of care: internists and emergency medicine physicians (both 4.50) and family physicians (4.52). Dermatologists (4.95) and ophthalmologists 4.85) had the highest scores for happiness at work.

In your job, you are running on the tracks of “the way we do things around here.” These are still not your tracks. You did not lay them. Burnout is when you figure out how to lay your own tracks or better yet, realize you are a four wheel drive vehicle – not a train on tracks. You can navigate any terrain you choose. - Dike Drummond MD (The Happy MD)

Let’s Keep it Simple What is an Ideal Micropractice? Why do such a thing? How to take the leap? Pearls and pitfalls Year 1 results

How to take the leap Map out your value system – your practice will be a direct extension of you Seek advice (*not approval) from trusted family, friends, and mentors Call yourself something, put an actual name to your vision Step forward and don’t look back

Must have skills Medical knowledge/ability Compassion/empathy Blue-collar work ethic/self-reliance Networking/promoter Organizational ability/motivator

“It’s the lack of faith that makes people afraid of meeting challenges, and I believed in myself.” - Muhammad Ali

Let’s Keep it Simple What is an Ideal Micropractice? Why do such a thing? How to take the leap? Pearls and pitfalls Year 1 results

Pearls and Pitfalls Start the credentialing process as early as possible Negotiate everything; cut start-up and operational costs wherever you can Supplement income if possible (teaching engagement, locums, etc.) Find trustworthy staff members and train them well Design protocols across the board (phone answering, medical procedures, etc.) Walk in the patient’s shoes (simulate your office experience) Stay true to your vision but always ready to adapt

Let’s Keep it Simple What is an Ideal Micropractice? Why do such a thing? How to take the leap? Pearls and pitfalls Year 1 results

Year 1 results Community micropractice model has been well-received Local publicity has helped to develop our brand Referral sources find value in our service Has spiraled into other opportunities (PM&R directorship position, consultation engagements, and more) Addition of a friend and colleague…

Thank you.