In April 2008, I elected to proceed with establishing a solo private gynecological practice. At the time my primary reason was to establish a practice that was solely managed by myself without dealing with the bureaucracy of multiple partners and various goals. Since that time, I have come to realize that the reasons are far more complex. I have delivered over 6,000 babies in the last 28 years. I thoroughly enjoy my work. I have taken great pride at delivering infants and have always felt that it was an honor to be put in this position. I have never taken that position for granted. Nonetheless, as my youngest child is entering middle school, I can now see that the time spent with my family is invaluable. I made efforts in the past to be with my family as much as possible, but it is not technically possible to do that when you are essentially on call 24-hours a day every other or every third day for 24 years.

In addition, since I have made this move, I realize that medical practices are changing significantly. The bigger a practice gets, the more work is created for each physician. It is very common now to wait two to four months to see a physician, and quite commonly you end up seeing a different physician or a substitute health professional, which is not a medical doctor. How often have you heard the monotonous frequency of, “Sorry I’ve kept you waiting.”?

It was not uncommon for me to see 35 to 45 patients per day. I would schedule patients every 15 minutes, but likely see them with greater frequency due to patients that needed to be worked in. The joy of health care had diminished significantly. Pursuit of revenue cut into the time needed to build trusting relationships with my patients. I lost the joy in the work and began to feel that I was no longer making meaningful contributions to my patients’ lives but merely going through the motions to receive a paycheck.

On April 15, 2008, I established a new practice, Women’s Healthcare, PC. This is what is referred to as a “micro” practice model. This practice focuses on optimizing the smallest functional work unit capable of delivering excellent care with one doctor and three ancillary personnel to optimize efficiency. Patients are scheduled every 30 minutes. Typically, I will see eight to ten patients per day. The waiting room is normally seen with one or two patients. There is no rush. We are on time. We will not feel hurried or pressured in any way. We work patients in the same day. The key principles of this practice are to pursue high quality, patient-centered, collaborative care, unfettered access and continuity, and extreme efficiency. The care team uses the most advanced technology, such as electronic medical records, emailing patients, and internet scheduling. The patients can see me whenever they choose. The practice is proactive in allowing women to take responsibility for their health care. The educational process is paramount. This practice empowers women to make intelligent health care decisions. 

I refer to this as the “Ideal Medical Practice.” This is not a new concept but is catching on across the country, primarily in family practice offices. I am happy to say that since I have been here, this has been well-received by my previous patients and new patients.

--Thomas J Getta, M.D., F.A.C.O.G.