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Are you waiting for Health Train Express on the train platform? Have a seat and call  911.

If you are at all wondering if your doctor will be there next time  you call,  you are operating in reality. In a recent survey sponsored by a well known EMR vendor the results are stunning.  Practice Fusion’s independent consultants found the following:

Key findings:
* 41 percent of doctors report that their practice is doing worse this year compared to last year. Compared to 26 percent who report their practice doing better and 31 percent report no change.
* 59 percent report that new technology has made things easier for their medical practice.
* 73 percent report that the computers in their practice are over three years old on average (21 percent in the five to six-year-old range).
* 69 percent of doctors report being satisfied to extremely satisfied with their career despite these challenges.
* Doctors were also asked to report their practice's top negative pressures and positive trends in a series of open ended questions.
* Issues relating to practice administration (31 percent), insurance and reimbursement (26 percent) and difficult patients (11 percent) are the top negative pressures on the practices.
* Positive trends are led by advancements in medicine (22 percent), patient quality (19 percent) and improvement in the healthcare workforce (15 percent).
* 80% of US physicians practice in groups of 9 or less according to the AMA.

View Practice Fusion's 2011 State of the Small Practice info graphic. Raw data from the survey is available free upon request. Practice Fusion is also offering physician sources across the country to talk about their own experiences managing a small practice.
Survey Methodology
The Practice Fusion State of the Small Practice study was conducted by internet survey in December 2010 with MDLinx. Responses to 10 questions were collected from a national sample of 100 physicians. The majority of respondents were primary care providers in practices with fewer than six providers.

Admittedly this was not a very scientific study, nor was their any indication of the demographic of the study group, not taking into account the geographic location, age of the physician, or medical practice. The statistic lumped all small practices from 1-9 physicians.   That is quite a spread. The resources of a one or two man group are far different than  three or more individual practitioners.

"Small primary care medical practices are the backbone of the US healthcare system," said Ryan Howard, CEO of Practice Fusion. "These are family doctors on the front lines, they're passionate about caring for their patients and our survey indicates  that they're struggling. “

EMR vendors as part of their service will evaluate a medical practice for implementing a system. This includes a thorough analysis of costs and return on investment.  They know the financials  within which physicians operate.  If anything they are biased toward selling their system,, and having a client be able to purchase and pay for it.

This survey by Practice Fusion (which offers a totally free EMR which operates in the cloud) points out that even with a ‘free EMR”  practices cannot afford the down time or the cost of minimal hardware investment.

Most small practices, and larger ones are operated with less than optimal physician/staff ratios.  The staff has to be multi-tasking in their job description. This is not always possible.

How many times do  you receive an answering machine when you call the  doctor’s office?  My observation is it occurs a great deal of the time. The message is ‘if it is a medical emergency to call 911 or go to the emergency room.” 

How about that for improved quality of care?  Government studies do not measure that metric, “the first mile to the health care system”.

Let me have your thoughts on this matter.

You can tweet me @anophthalmus, or leave a message on facebook/garylevin

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