Health & Wellness

Guest Column

Bring Back the Solo Physician

efe17b0658fb79609102_Kewalramani_1390_Final.jpg
Dr. Kavita Kewalramani is an Internist with a solo practice in New Providence. Her practice is unique and integrates primary care, medical weight loss and lifestyle & disease management programs.
efe17b0658fb79609102_Kewalramani_1390_Final.jpg

As far back as we can remember, the hallmark of American medical care was that solo physician who greeted you by your first name and inquired about your family. He/she then directed you to the exam room and patiently discussed your concerns. After going over treatment recommendations and addressing your concerns, he/she finally waved good-bye.

Today the experience of an office visit is starkly different. Because of shrinking reimbursements and time constraints and the demand for productivity, physicians are able to spend only a few minutes with a patient, before they rush out to see the next patient. “We simply don’t have the time,” physicians confess.

Sadly, the solo physician is a dying breed. Residents fresh out of residency are no longer motivated to start a practice of their own. Instead, they are enticed by offers from hospitals or multispecialty physician groups where they don’t have to worry about overhead costs or administrative requirements. “Work-life balance is better this way,” they agree.

Sign Up for E-News

In a large part, the shift from small to large practices has been driven by health care reform. Competition and poor reimbursements have fostered the growth of larger physician practices that share resources and are able to strengthen their negotiating position with insurers. Hospitals are following this trend and are buying up physician practices to increase leverage with insurers and to integrate care for patients.

In addition, Medicare pays much more for many procedures when performed in a hospital outpatient clinic rather than an independently owned medical office. Even 15 minute doctor visits pay more when done by a hospital-based doctor than a privately owned medical office. It is no surprise then that hospitals are buying doctor practices to take advantage of this difference.

Furthermore, employers, insurers, and government are burdening physicians with extensive reporting requirements for patient cost and quality that are difficult for small groups and solo practitioners to manage. Solo and small practices may lack the resources that are needed to collect, manage, and report data, particularly in the age of electronic health records.

It’s time to bring back the solo physician and small practices. Health care reform has not taken into account patient experience and effectiveness of the medical visit. Patients and physicians deeply value the personal relationships that smaller practices can nurture. For younger patients, physician interaction is key to understanding the importance of diet and exercise in preventing chronic medical problems including obesity, diabetes and hypertension, which have risen over the past decade. Patients need time to build that rapport and relationship with one primary physician so that they are motivated to follow preventive care recommendations. For older patients, the care of a personable, nurturing physician is key to managing chronic medical problems and end of life concerns. The value of smaller practices is also particularly seen in rural areas, where the closest hospital could be miles away.

An important study by Lawrence Casalino et al., funded by The Commonwealth Fund, revealed that patients of physicians practicing in solo and small practices have lower rates of preventable hospital readmissions than those in larger practices. The study explained, “It is possible that small practices have characteristics that are not easily measured but result in important outcomes, such as fewer ambulatory care–sensitive admissions. For example, there is evidence that patients in smaller practices are better able to get appointments when they want them and better able to reach their physician via telephone, compared to larger practices. It is also possible that physicians, patients, and staff know each other better in small practices, and that these closer connections result in fewer avoidable admissions.”

We need to help solo physicians and small practices survive. We need to implement health care reform that gives independent, private-practice doctors an equal footing and encourages small physician practices to share resources and come together to have leverage with insurers. Government needs to develop payment models that include grants or loans for solo practices to invest in necessary infrastructure so that they can alleviate mounting overhead costs.

Most importantly, we need to empower patients to lead healthier lifestyles. The key to better health lies in the care of that personable and nurturing solo physician.

Dr. Kavita Kewalramani is an Internist who started a solo practice in New Providence, New Jersey in August 2015. Her practice is unique and integrates primary care, medical weight loss and lifestyle & disease management programs. Visit K Primary Care & Medical Nutrition Center website for more information. 

The opinions expressed herein are the writer's alone, and do not reflect the opinions of TAPinto.net or anyone who works for TAPinto.net. TAPinto.net is not responsible for the accuracy of any of the information supplied by the writer. Click here to submit a Guest Column.

TAP Into Another Town's News:

You May Also Be Interested In

Sign Up for E-News

Warren

Missing in Green Brook: Have You Seen Riley?

June 17, 2018

GREEN BROOK, NJ - Have you seen Riley? 

Riley’s family says, “Please help. I’ve lost my dog. Somewhere on 22 in Green Brook. His name is Riley. He is a black and silver beagle.  He is scared of people. So just grab him by the collar. He is very friendly and won’t bite or attack. Or just call us at 732-266-2822 or 917-596-4869. Much appreciated. We are so ...

Warren Financial Planner Fined $500K, Barred from Selling Securities for Defrauding Seniors of $6.1 Million, NJ Attorney General Says

June 16, 2018

NEWARK, NJ –  A Warren resident and his company, a Morris County investment advisory firm, were fined $500,000 in civil penalties and barred from selling securities for fraudulently selling at least $6.1 million in unregistered securities to elderly and retired New Jersey investors, Attorney General Gurbir S. Grewal announced on Friday. 

The Bureau of ...

Horse Care Workshops at Lord Stirling Start June 23

June 17, 2018

BASKING RIDGE, N.J. — Somerset County Park Commission Lord Stirling Stable is offering Horse Care Workshop 101 for adults and youth seeking to gain experience and confidence around horses through a combination of non-riding activities and hands-on practice.

Horse Care Workshop 101 will be held at Lord Stirling Stable, 256 South Maple Avenue in Basking Ridge, NJ beginning Saturday June ...

Elks 150th Anniversary

Founded in New York City on February 16, 1868, the Benevolent and Protective Order of Elks (BPOE) is celebrating its 150th Anniversary this year. This non-political, non-sectarian and strictly American Fraternal Order was founded "To promote and practice the four cardinal virtues of Charity, Justice, Brotherly Love and Fidelity; to promote the welfare and enhance the happiness of its ...

Upcoming Events

Carousel_image_c0dcc5b06e5dfbe83904_vbs2018-banner

Mon, June 25, 8:45 AM

Stonecrest Community Church, Warren

Summer Spectacular 2018 VBS

Religions And Spirituality

Carousel_image_c0dcc5b06e5dfbe83904_vbs2018-banner

Tue, June 26, 8:45 AM

Stonecrest Community Church, Warren

Summer Spectacular 2018 VBS

Religions And Spirituality

Carousel_image_c0dcc5b06e5dfbe83904_vbs2018-banner

Wed, June 27, 8:45 AM

Stonecrest Community Church, Warren

Summer Spectacular 2018 VBS

Religions And Spirituality

Obituaries

Jul 28, 1955 - Feb 8, 2018
Owner/Chef of Jaret’s Stuffed Cupcakes  Beloved Husband, Father, Brother and ...
Read more

Manutti Marina in Belmar: Top Choice for Boating, Fishing and All-Around Family Fun

June 12, 2018

BELMAR, NJ — It’s no secret that Belmar Manutti Marina ranks among the best boating destinations along the Atlantic coast.

Tucked along the eastern shoreline of the idyllic Shark River — just a five-minute trip by boat to the ocean — the state-of-the-art marina is a top choice among boaters looking to stay for the season, enjoy a vacation or spend the weekend.

In ...

Missing in Green Brook: Have You Seen Riley?

June 17, 2018

GREEN BROOK, NJ - Have you seen Riley? 

Riley’s family says, “Please help. I’ve lost my dog. Somewhere on 22 in Green Brook. His name is Riley. He is a black and silver beagle.  He is scared of people. So just grab him by the collar. He is very friendly and won’t bite or attack. Or just call us at 732-266-2822 or 917-596-4869. Much appreciated. We are so ...

To Our Republican Supporters in Warren Township,

June 12, 2018

 

I want to thank the voters of Warren Township for the overwhelming support Gary and I received on the June 5th primary election.  This would not have been achievable without the hard work of our families, many friends and supporters as well as the loyal Republicans that cast a vote for us and our shared goals.  

 

The campaign is not over until the ...

Get Empowered to Help Prevent Suicide

Dear Editor:

Over the past week social media and the news have been filled with stories and articles encouraging people to seek help if they’re in emotional distress. There have been countless articles about the need to break the silence around the topic of mental health and suicide, and I am encouraged by the support people are extending to others.

Often, the death by suicide by ...

Watchung’s Rizzi Ties Record at Rotary Track and Field Meet, North Plainfield Middle School Dominates in Awards Tally

June 9, 2018

PLAINFIELD, NJ - With an overcast sky and pleasantly cool temperatures, young student athletes from area middle schools and one elementary school gathered for the 91st Annual Rotary Track and Field Meet, held June 6 at the Hub Stine Athletic Complex in Plainfield.

Vincent Rizzi, holder of the Meet high jump records for boys ages 12 and 13, tried valiantly to best the 14 year old boys’ ...

SCBP Biz Fest 2018 Draws Record Crowd

June 17, 2018

SOMERSET, NJ - More than 500 people attended Biz Fest 2018, Somerset County's ‘hyper-local’ trade show and networking event, on Thursday at the Imperia.

The Somerset County Business Partnership (SCBP) organized the event.  SCBP Vice President of Business Services Chris Edwards said that this year's Biz Fest was a huge success. 

"This has been ...

Update: Police Break Up Fight Involving 40-50 People at Bridgewater Commons Mall

BRIDGEWATER, NJ — No injuries have been reported in an incident that shut down Bridgewater Commons Mall Thursday evening after a fight involving a crowd of 40-50 people.

Police are still investigating unconfirmed reports of shots being fired, according to the Somerset County Prosecutor's Office.

The mall is closed for the evening as the investigation continues.

Somerset County ...

March for Watchung Library and Rally Set for Saturday

WATCHUNG, NJ - Supporters of keeping a Watchung Library in Watchung have organized a March For Watchung Library to be held on Saturday, June 16. 

The Coalition to Save the Watchung Library is rallying support and have asked all who want to participate to “paint a sign, put on some purple, and come out and join your friends and neighbors for a Rally on the Green and ...

Long May It Wave: Elks' Festival Salutes American Flag

 

SOMERVILLE, NJ The Somerville Elks are hosting their annual salute to America, patriotism and the American Flag  June 15 on the green adjacent to the historic Somerset County Courthouse on East Main Street, beginning at 5 p.m.

The Flag Day Country Music Festival features “Big Hix,” a country/western tribute cover band that takes the stage at 7 p.m. for a free ...

Manutti Marina in Belmar: Top Choice for Boating, Fishing and All-Around Family Fun

June 12, 2018

BELMAR, NJ — It’s no secret that Belmar Manutti Marina ranks among the best boating destinations along the Atlantic coast.

Tucked along the eastern shoreline of the idyllic Shark River — just a five-minute trip by boat to the ocean — the state-of-the-art marina is a top choice among boaters looking to stay for the season, enjoy a vacation or spend the weekend.

In ...