Magazine article Medical Economics

"I Never Wanted to Be Rich"

Magazine article Medical Economics

"I Never Wanted to Be Rich"

Article excerpt

Richard Bates spent his entire 35-year career as a fee-for-service solo practitioner, a species he now fears is "as passe as the druids, dinosaurs, and dodo birds," thanks to managed care.

Bates usually saw only a dozen patients a day in his Lansing, Mich., office. The average visit lasted a half-hour or more, and he gave a full hour for physical exams. "Few of my patients were really sick," he explains. "Most were the worried well. They had become my friends as well as patients, and we'd have long talks about their personal problems. Many were lonely, and those visits with me were their only chance to unburden themselves. I helped them deal with life's changes, including retirement, and that helped me plan for my own."

Because of that close relationship with his patients--and the fact that he didn't perform any surgery--Bates never faced a malpractice suit. In fact, during the last 10 years of his practice, as liability premiums rose sharply, he went bare.

"I never tried to build the practice," says Bates. "In fact, we turned away new patients every day. I had all I could care for responsibly. Besides, I have a character defect: I never wanted to be rich.

"A large practice doesn't convince me that a doctor is popular or good," Bates continues. "It may mean that he's insecure, undisciplined, or greedy. If a doctor refuses to prune his practice, it may outgrow his time and concern.

"Too many doctors go into medicine today for the money, which doesn't attract people with compassion. …

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