Letters: Readers comment on Medical Economics stories

More ways to volunteer

I read with interest your physician's guide to volunteering [January 23, 2009]. You may want to spotlight Project Access sites around the country as well (learn more at http://www.physiciansinnovation.org/about/communities.php). Project Access programs are comprehensive networks of volunteer primary and specialty physicians who provide free healthcare to low-income, uninsured residents.

MIRIAM SCHWARZ, MPA
Asheville, North Carolina

By the time I had finished reading "An insider looks out" by Dr. Jonathan Roylance [January 9, 2009], I found myself in tears. Not only is this one amazing man to have come through so much and be able to share his ordeals with the medical community and the world, but in person this man is as wonderful a doctor as I have ever met.

I am also from Marietta Memorial Hospital in Marietta, Ohio. I am a critical care nurse of about 10 years, and I have worked with Dr. Roylance for just over a year. He is a kind and compassionate man who has not only offered a wealth of knowledge for those who work at his side, but also a wealth of encouragement, faith, and hope for those patients fortunate enough to meet him.

Our jobs are stressful and sometimes heartbreaking. Our personal lives sometimes get neglected. Sometimes it seems that our jobs are thankless and that no one sees what we do. For these reasons and many more, I must say thank you, Dr. Roylance. From all of those who have had the pleasure of working with you, from all of those who have learned from you, and from all of those whom you have so compassionately cared for.

ELIZABETH CONNER-RIEGEL, RN
Marietta, Ohio

Brushes with mortality

I, too, am a physician and was an "interesting case," being a vasospastic angina patient who ended up suffering an episode of ventricular tachycardia and sudden cardiac death. I ended up with a defibrillator, which has never been needed, thank God. I enjoyed "teaching" the residents, but coming face to face with my own mortality was difficult.

COLEEN WHEELER, MD
McDonald, Pennsylvania

Making matters worse

I was struck by your article "10 steps to a better practice" [December 19, 2008], particularly the "get control of your schedule" segment. If working through lunch can provide slots for more patients, how about working through breakfast? Or dinner? Heck, put the doctor on TPN and squeeze out 20 more visits a day. Most of your suggestions merely make the office visit experience worse for the doctor and patient. No attractive waiting room, patients told to call back at a time more convenient to the doctor, hiring more staff to control paperwork: All of these steps exacerbate the problem of overworked, underpaid doctors and dissatisfied patients.

Doctors need to opt out of the insurance-controlled practice model and take real control of their practices. Only then will both doctors and patients be content.

JANET FUCHS, PHD
Beverly Hills, California

Concierge dreams

I am surprised by Dr. Grugle's comments [Talk Back, November 21, 2008, in response to "How to set up a concierge practice," http://memag.com/concierge]. It is obvious he does not understand that primary care physicians do not get "filthy rich" in a direct-practice model.

Unethical? The idea that a primary care physician has a patient base of anywhere from 2,000 to 5,000 patients and has to comply with the directives of non-medical personnel in the delivery of sickness-based medical care to patients seems a lot more unethical than the idea of allowing more time to accomplish wellness and preventive care to patients.

I do not have a concierge practice, but this sure makes sense to me. Maybe this model may encourage medical students to go into primary care medicine. Perhaps healthcare costs in this country would decline as more and more people are taken care of from a truly preventative approach.

BEN GONZALEZ, MD
Silver Spring, Maryland