I closed my panels to random assignments from insurance plans very early (about 500 patients) which was a good idea for my practice. My new patient visits, with spending an hour and then additional time organizing a chart in the EMR, were taking up a lot of energy every week. What now happens is that all my referrals are by word of mouth and I have the space still to take friends, family members, people in my community. The practice has grown much more "organically" that way and looks more like a community practice than I ever would have suspected in a city of 500,000. I now have about 850 patients and still have room for more. 
Nancy

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