Solo doctors tapping IT to stay independent

Perhaps the solo medical practitioner has been underestimated when it comes to technological savvy.  

Consider the case of Jed Shay, MD, who runs the Pain Care Center in Rock Springs, Wyoming — one of the most remote towns in the nation's least populous state. Shay has built a profitable practice by using telemedicine to care for remote patients and cloud-based software to properly bill for reimbursement.

"In a small community, you are not drawing from a pool of people knowledgeable about medical practice operation," he explained. "There's a reliance on technology. You have the ability to architect your [business] using available EHR and practice management systems."

Maintaining independence
Despite staggering odds, independent physicians increasingly trust technology to help them meet daily operational challenges.

Slightly more than one-third of U.S. physicians were practicing independently as of the end of 2013, down nearly 20 percent from the turn of the millennium. Among the estimated 282,000 doctors who've opted to be self-sufficient rather than employed by others, the cost of running a business remains their top concern.

Further west, in Oakland, California, Steven Lovato, MD, is asserting his independence using mobile technology while seeing 30 to 40 patients per day at his two-office family practice.

An iPad app from AdvancedMD provides a gateway for Lovato to access EHR, billing and scheduling systems, whether he is seeing patients at the Oakland office (three blocks from his childhood home) or 50 miles away at a satellite office in Stockton.

Lovato said the app enables him to dictate notes and orders for each patient visit, thereby cutting down on charting time.

"Being able to dictate on the app using voice recognition was huge for us," he noted. "We formerly used contract transcriptionists, which cost us about $500 to $600 per month. And now we have instantaneous access to the notes."

Eyeing the future
Keeping one’s independence, of course, is not a one-time decision or implementation. Rather, it’s an ongoing process to keep pace with the technologies that practices have come to depend upon.

For Lovato that means serving as a beta tester for a new iPhone version of the AdvancedMD app, which will include e-prescribing — a function that has been on his wish list.

Shay, for his part, has received government incentive payments for being an EHR meaningful user, and he plans to attest for MU Stage 2. The Pain Center is also prepared to convert to ICD-10 coding when that transition takes place next October and is looking forward to the conversion as it will provide more insight about whether he is charging properly and what that means to his own practice.

Whether it’s essentially transcending space and time to serve more patients with mobile apps and telemedicine, or gleaning practicable operational insights about a medical group via new tools, one thing’s for certain: To stay afloat solo doctors and small medical groups are must turn to technologies that help them better treat patients and simultaneously drive down costs.

Is your small or solo practice turning to technology as a means for maintaining independence? I’d love to hear more about it, so please write to me at

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