From: "Dr

From: "Dr. Annie Skaggs" <askaggs@fayettefamilymed.com>
Sender: Practiceimprovement1@yahoogroups.com
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Date: Fri, 13 May 2005 11:51:15 -0400
Subject: [Practiceimprovement1] Reply to Gary and greetings to all.
Reply-To: Practiceimprovement1@yahoogroups.com

Hi Gary,

Feel free to use/adapt as you please. Sorry I have been slow to get back to

you on this; I was getting ready to go on vacation. Here is a message I

want to send to the whole group. Hope you don't mind if I piggy back it onto

my reply to you.

Greetings to all you hardworking Family Docs from the sunny waves of Key

West:

I am just finishing up my first week of vacation in a little over a year,

and I want to A)Thank all of you (especially Gordon for pointing out this

path) for all the advice and suggestions that have added up to making this

trip possible; and B)Confirm that it *is* possible to practice solo and

still have a life.

I am by no means making anywhere near the income that I expected when I went

into medicine, but taking this week off is not going to break me, especially

because I am not paying for staff to run an office that I am not in. By

using the technology that I have been putting in place over the past 2 1/2

years, I am able to be here, enjoying myself 23 hours of the day, and have

been able to respond to patient needs that can't wait the other hour each

day (right before Happy Hour!) I have been able to record a message on the

office phone that says 'I'm away but if you need me I'll call you back'; it

also gives the name of another solo doc in town who will see them if it

really can't wait-but no one has used that option; I check the messages, and

also the faxes, and return all the calls; I schedule appointments for after

I get back, and I phone or fax short term refills for the folks who already

ran out of their meds, or will before I get back. I have prevented three ER

visits by reassuring anxious people that the symptoms they describe do not

sound life threatening (like the guy who had a radical prostatectomy last

week, then got readmitted for pneumonia, but called me because he can't

sleep and thought Levaquin was causing insomnia--he thought maybe he needed

to go the ER to get the levaquin changed to something else. After talking a

few minutes about the stess of a life threatening cancer diagnosis, a major

surgery, a complication of hospital acquired pnuemonia...no wonder he's

feeling scared and having trouble sleeping! He's going to try a few

behavioral modifications and a little Tylenol pm and call me again if things

worsen.)

I have fielded about 6 calls and 8 faxes each day, and have had to spend

$8/hr for highspeed access. Of course the services I am providing will not

generate any income, but that's the trade off. If I were home, I would

require an office visit for refills or acute problems. Patients can't very

well just run down here to see me, so I have provided "telecare" that I

would not ordinarily do. Everyone has been extremely pleased that I called

them from my vacation, and all have limited the length of calls and number

of issues they wanted to address. It seems like a reasonable compromise for

now, but someday I hope to make those services pay a little.

Anyway, I am here and grateful for the chance to relax. I wish the same for

all of you! Thanks again.

Annie Skaggs, MD

Lexington, KY (but Key West at the moment)

Solo 2 1/2 years, Nurseless 18 months

emr = Healthmatics from A4