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Startup Spotlight | Oct/Nov '13

I Don’t Have a Personal Office

In the previous issue I wrote about how I didn’t have a biller. Keeping overhead low is the true key to success for running a practice. In that vein, I do not have a personal office. At this point some of you are probably joking “no biller, no office, no patients,” but the truth is that the future of health care is very uncertain. To survive any changes that come our way, lean and mean is the way to run a practice.

Let’s take a step back in history. There was a time when a patient would go to his or her doctor. The patient would be taken into an exam room where the doctor would evaluate him or her. Then he or she would dress and meet the doctor in his or her office where they would discuss the findings. That rarely happens today. In ophthalmology, it never happens. So what is the private office used for today? In my past position in an academic center, for me it was a place to hide from patients, wolf down a sandwich, and catch up on patients’ charts and callbacks.

So, what has changed? Due to my low overhead I don’t have to see tons of patients who are frustrated about their wait times. Patients are seen on time almost every visit. I now have a longer break scheduled so I can actually get out of the office if I want to eat lunch. My patients’ charts are in the cloud so I can access them from anywhere. My office is wherever I am as long as I have an phone, iPad, or laptop with me.

Watch a video on CareCloud.

In September’s edition I mentioned that I didn’t have a biller because my EMR (EMA Ophthalmology from Modernizing Medicine) and practice management systems (CareCloud) do the coding/posting/tracking of charges all for me. I also don’t use a scribe because the EMR system is intuitive and fast. Charts in the cloud means no back room required for their storage. No scribes, no billers, small office space—removing all of these expenses gives me the freedom to say, “I don’t need to be on this HMO or that capitated model.”

So, how does it work in practice? Great! I see fewer patients and am more profitable per patient than my colleagues. If a patient needs a medication refill over the weekend, I know what he or she is using, which pharmacy, and with a couple of mouse clicks, I can refill the patient’s drops from home in a few seconds. I can be out of town and, should a patient have an emergency, I can send any past records to a covering colleague in seconds. Patients appreciate the on-time, personalized care they receive, and I am able to go to work every day loving what I do and get home in time to play with my children. This is the evolution of the ophthalmology practice.

David A. Goldman, MD

David A. Goldman, MD, is the founder of Goldman Eye in Palm Beach Gardens, Florida. Dr.Goldman may be reached at (561)630-7120;david@goldmaneye.com.