COMMENTARY

Walking the Dog and Fetching Happiness in Your Practice

Allan M. Block, MD

August 26, 2021

To go back to last week's column, some of the best advice I ever got came from those early days when I was just starting my solo practice.

Dr Allan Block

One of the family docs I met was a bit off the path. He was in a small medical building, maybe three to four offices total. It wasn't rundown, but was obviously an older building, and not located near the hospital.

When I went in, it was clear he'd been there a while, and hadn't bothered to redecorate at all (granted, in 2021, neither have I). The lobby reminded me more of my grandparents' living room than a medical practice. I watched as the receptionist artfully ran through answering several lines, putting people on hold, and scheduling appointments, before she turned to me.

As soon as I started my spiel ("Hi, I'm a new neurologist in the area") she got up and went to get the doctor. She said he always wanted to meet the new doctors who came in.

Charlie took me back to his office. His desk was covered with charts in no obvious order, and the bookcases with various journals. There was a feeling of comfortable, intentional, messiness.

He was 67 at the time, obviously still enjoying his work. He told me he'd been in solo practice since day 1, recommended it to all starting out (23 years later I'll agree with that), and offered me this piece of advice:

"Treat your practice like you would your dog. Enjoy it, take care of it, and it will serve you well. But never, ever, let it be your master. If you do, you'll be miserable. Raise it the right way and you'll always be happy."

After the brief meeting he walked me up front and I went on to the next office.

In the years to come I encountered him on and off rounding at the hospital or sending each other letters about a patient. He retired a few years later and died in 2007.

I still think about him. I've had one practice and owned several dogs during that time, and he was really right.

In solo practice I probably haven't made as much money as I would have in a larger group. But I have more time to do as I wish, no one else to argue with me about a new direction for the practice, computer upgrades, or staff changes. I see, within the limits allowed by my overhead, as many or as few patients as I want. I can take vacations and days off. I have time to goof off with my staff and spend extra minutes with patients who need it. Medicine is a high-stress field, but at least I can keep the stress as low as possible.

On the flip side, I see the people he warned me about. New docs who come out with guns blazing, cramming their schedule as full as possible until they can't possibly see more patients. Their staff gets overworked and has a high turnover. They themselves burn out quickly and either melt down or close down.

So I'll pass the same advice to all others starting out. I still recommend solo practice. And treat your practice as you would your dog. Let it be your loyal friend, but never let it run your life.

As I say to my dogs every day, "you guys are awesome."

Allan Block, MD has a solo neurology practice in Scottsdale, Ariz.

This article originally appeared on MDedge.com, part of the Medscape Professional Network.

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