Happiness-Based Musculoskeletal MedicineThe Ideal Micropractice 1012015 AAPM&R National ConferenceJustin Berthold, DO – PM&R

Who am I?Justin Berthold, D.O.

Physical Medicine & Rehabilitation Physician Focus on restoring function and quality of lifeTreat 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 Success1. ACCESS

Patients have unlimited access to the care and information they need, when they need it.

2. INTERACTION Interaction between the patient and care team is deep and personal. The care team

has “memory” of the patient.

3. RELIABILITY The system exhibits high reliability in that it provides all and only the care known to

be effective.

4. VITALITY The practice has vitality: happy employees, a spirit of innovation and financial

viability.

A Wise Mentor’s 3 Pillars of Success

1. AVAILABILITY

2. AFFABILITY

3. 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 1. High-quality, patient-centered, collaborative

care2. Unfettered access and continuity3. 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

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

Physician Burnout

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

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

How to take the leap

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.