I am sure the day will come when I’m ready to settle down in a particular zip code. Until then, I enjoy flexing my time between different cities and countries. That’s why I decided on a virtual primary care practice instead of a physical one.
A virtual practice also cuts my overhead – no rent or commercial real estate mortgage, OSHA compliance, lab certifications, or workman’s comp insurance for on-site employees.
A Virtual Medical Practice
On a workday, I wake up around 9 am, check my email and Whatsapp, and enjoy a cup of dark roast coffee, usually fresh-ground, while reading a book.
I don’t schedule my patient appointments until later in the day after I’ve legitimately awoken. Even then, it’s rare for me to have more than 5 virtual patient visits per day.
Most of my calls I can complete while enjoying a walk outside, while others require a video visit or screensharing. It’s this flexibility which makes the virtual practice so sustainable.
The Traditional Medical Office
Though I’ve never owned my own physical practice, I have worked as a Family Medicine or Urgent Care doctor in many settings. The overhead of such a practice is financially and emotionally taxing.
The logistics involve having someone open the office in the morning after the cleaning staff had their way with it. Next, computers have to be turned on, the temperature brought up to a comfortable temperature, and parking figured out.
A physical medical practice also needs staff – some who might not be able to make it because they are taking care of a sick loved one, have car trouble, or are stuck in traffic.
In a physical office, we have utilities, insurance, and hardware to secure. That’s a lot of overhead and headache, little of which directly benefits my primary care patients.
The Right Practice for the Right Patient
Some primary care doctors offer the whole gamut from performing biopsies to delivering expectant mothers in the hospital, from inpatient medicine to rounding on nursing home patients and performing pelvic exams.
When I left the insurance model in 2016, I realized I had to do much more talking, connecting, and listening instead of performing procedures, billing, and lecturing.
This is perhaps because a sustainable primary care practice that focuses on patients often prioritizes prevention over treatment.
Then again, some patients benefit and prefer the intimacy of an in-person visit. The touch of a caring clinician, the physical examination, and the ability to obtain vitals are all critical aspects of certain primary care visits.
As a physician myself, my primary care doctor is virtual. I rarely need a physical exam, my tests can be performed in a lab or radiology center, and if vitals are needed, I’m often sick enough to go into the Urgent Care or ER.
Passing the Cost Down
There is a passthrough effect when the overhead is lower. It’s not just about the cost savings from not having a physical practice but also encourages me to do more with less.
My patients who are perpetual travelers need a PCP like anyone else. The prospect of having an in-person visit every time is daunting. And talking to a new doctor on a telemedicine platform like Teladoc is tedious.
The numeric cost savings, perhaps, is now apparent. And the time and financial cost savings speak for themselves when reviewing the data on better health outcomes in those who have established PCP care.