Friday, January 13, 2017

Five Year Anniversary of Happiness-Based Medicine

I’m very proud to share that I’m five years in to what started as a gutsy new venture, a happiness-based sports medicine clinic.

I opened Lake Washington Sports & Spine in 2012 when independent private practice physicians were committing mass mutiny and enlisting as employed physicians with large health care systems and hospitals.  In fact, all of my prior partners made that choice.  

I was scared, and knew failure was possible, if not probable.  The first year presented many challenges to developing our happiness based medicine philosophy.  First of all, I had no idea how to run a business, and I made a series of bad choices.  Fortunately, I learned from mistakes, and more importantly, I chose to employ a budding star as my practice manager, Laura Cassidy.  

Several challenges were overcome.  Laura and I struggled together through some bad hiring decisions.  She brought a ray of clarity to my muddy management.  It was so hard for me to fire employees that were a bad fit, but I did.  I learned that finding employees who are the right fit is more charitable than keeping a poor-fit, struggling one.

I contracted with a lousy electronic health records company for 6 painful weeks before cancelling the contract.  We migrated to our present, decent, cloud based platform.  It took 6-8 months to develop competence in this new system, but five years later this was clearly the correct choice.  

I made many frugal decisions, and even so I essentially did not earn any money my first year in practice.  That was a great sacrifice for me and my family, especially when taking into account the opportunity cost of what I would have earned as an employed physician.  I avoided taking on debt whenever possible.  For example, despite some outside pressures and advice to the contrary, I elected to not spend thousands of dollars to convert thousands of paper records into electronic format.

We learned that we couldn’t control the office culture while sharing space, even with gracious orthopedic colleagues.  I’m very grateful to my Bellevue Bone & Joint colleagues for providing me the opportunity to set up shop in their midst.  Their was an element of symbiosis to our practice, though in the end I never felt that I could fully express myself within their office.  We moved into our own office space, taking over ~1800 square feet in the Bellevue Medical Park from the retiring David Ferrin, Internist and Cardiologist.

About 1 year in to the venture there was a second sentinel event (the first being Laura’s hire).  I hit a milestone.  The practice was running smoothly, and I was fortunate to have many patients coming through the door.  I knew part of my happiness-based medicine vision included working with a partner, and so one day I rather randomly and spontaneously elected to post a job opening on a national list-serve — this was against the rules by the way…and the posting was taken down within 2 hours by the list-serve operator.  But the "find-me-a-wonderful-happiness-based-medicine-partner” angels did their job.  My wonderful now-partner, Gary Chimes, saw the post.  Somehow he had checked this list-serve in the time between my post and its removal, and the stars were aligned and he was ready for a job change.  

Gary and I had already known one another for years, and in fact had shared hopes of a type of happiness-based medicine construct while teaching musculoskeletal ultrasound together at the American College of Sports Medicine national meeting.  We courted for 6 months or so over the phone until we were both comfortable that ours could be a sustainable marriage.  He migrated West from Pittsburgh and the next phase of the practice then began.

With Gary’s arrival came an exponential and profound period of growth.  Whereas I have a lot of unbridled energy, he carries the compass and reigns to give us direction.  Gary has mentored me, and our team, and we are stronger, and progressing directly on our journey towards happiness-based medicine.  

Together we designed our KPA mission (Keep People Active).  We believe we have the best sports medicine practice anywhere.  In an area where we have many wonderful colleagues, our differential advantage is our growth mindset, our independence and clear vision of excellent medicine.

Some thoughts and advice:

  1. Private practice is hard.  Guess what, so is being employed.  I’d choose private practice over employed practice any day.
  2. Being self employed is a must for a physician with a growth mindset.  
  3. Deliberate independent thought is critical to the survival of physicians as one of the two primary stakeholders in medicine (primary stakeholders = patients and physicians) particularly in this time of healthcare consolidation and rigorous ACA/CMS compliance requirements.
  4. Express gratitude as often as you can.  The expression of gratitude breeds feelings of happiness.  Gratitude leads to joy.  Joy leads to success.