Part-time Practice

Published in The New Physician, March 2005

(sidebar to “Babies on Board“)

There was a time when Dr. Erin Harris dreamed of becoming “a full-fledged country doctor, delivering babies, that sort of thing.” But four draining years in medical school, one year of family practice residency and one infant later, that’s all changed.

“Now I realize that I really can’t do that and have the life that I want,” says Harris, who became a mother in her third year at East Tennessee State University James H. Quillen College of Medicine and is in her second year of residency there. “I’m going to find a practice where I can structure things the way that I want them to be. I want to do three days a week, part time.”

Boutique Clinics

New Funding Source for Teaching Hospitals? Published in The New Physician, March 2004 Something odd happens when you dial the Pratt Diagnostic Center at Tufts-New England Medical Center (NEMC). A person picks up. This is quite a revelation for those of us accustomed to talking to our dogs while listening to recorded options for service. When the same person repeatedly apologizes for putting you on hold, you want to hug her and tell her everything will turn out OK. How strange, you think to yourself. And then, you remember: This is a concierge medical practice, where personalized service reigns for patients who can afford it. Although the Pratt clinic just opened its doors in December 2003, concierge or boutique medicine—retainer practices, if you prefer—isn’t a new idea. Since the mid-1990s, about 130 primary care physicians nationwide, fed up with managed care, have left their traditional practices to open a kind of VIP lounge of care. For an annual fee that once topped $10,000 and can now be found for as little as $1,200, physicians go above and beyond the usual call of duty for patients who sign up with their practices. Instead of 8-minute office visits, patients get 30 minutes; instead of waiting two weeks for an appointment, they get in right away or the next day. And the clincher: 24-7 access to the physician, via his personal pager. Concierge care patients must still pay for nonpreventive office visits; but they get special features with their annual checkups that other patients don’t, like more intensive screenings and comfier waiting rooms. It’s like buying a DVD versus a videotape.

Oh, the Places You’ll Go

 You may have been wondering what to do after medical school–or perhaps you haven’t had the time to even think about it. In any case, the possibilities are endless. Let these five physicians’ tales inspire you to explore your unique career opportunities. Your future awaits you.

The New Physician, September 2001

So there he was. The Jerk, in person.

Alice Brandfonbrener had no idea when she decided to go to medical school that she would one day wind up here, rustled from her office at Northwestern University in the comfy northern suburbs and called down to Chicago’s Van Buren “L” station, to treat a case of ordinary bronchitis. Of course, this case didn’t belong to just any ordinary throat. It was Steve Martin’s, and he was filming “Planes, Trains and Automobiles,” and if she didn’t get down there right away, well … ladies and gentlemen, I bid you to consider the cinematic disaster that might have unfolded. Did you laugh at “Planes, Trains … ”? Yes? Go tell Alice: “Thank you.”

The truth is, though, that the comedian’s cough was far less interesting than what comprises the rest of Brandfonbrener’s world as a physician in performing arts medicine. No, the Columbia University medical school graduate and Northwestern University professor doesn’t serenade her patients in the examination room; in fact, she’s not very musical at all. But what she does do is ensure that actors, musicians, vocalists, dancers and the like can perform their jobs without injury.

To the untrained, it might seem like a medical catering service for prima donnas with hangnails on their pinkies. But Brandfonbrener’s expertise–which she began to develop when she became the first staff doctor for the Aspen Music Festival in 1983–is widely sought after and highly technical. She learned, she says, “to combine traditional medicine techniques with knowledge of the instruments [the musicians] were playing, the way they were being taught, the way they were trained.”

And voila–a specialization was born. One that, despite managed care’s song and dance, is thriving among performers because it’s the only medicine that understands the real demands of their professions.

“We can speak their lingo,” says Brandfonbrener, who founded the Performing Arts Medicine Association. “We can ask about the medical symptoms they have, the aches and pains, in artistic terms. We can talk to them about what they can do–and avoid doing–in terms of their talents.”

Piano players, for instance, suffer from too much finger motion. They frequently don’t know how to use the full weight of their arms on the keys, and particularly in a classical musician who practices for hours, the physical effects can be devastating.

“We’ll see a lot of students right before exams or juries, because those are the times when they’re practicing the most and at the same time dealing with a lot of the emotional tension that goes along with it,” she says.

Many of the injuries she treats come as a result of poor teaching methods or just plain inhumane training hours. She spends a great deal of time educating performers and their instructors about healthy practicing.

And the field, she says, is growing, despite those within the industry who still believe her patients are “just neurotic musicians who were making it all up. This is life to these performers; their talents are what drive them.”