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More and more family docs are leaving solo practices because of high costs and lower reimbursements. Many are joining large practices since they are able to negotiate higher reimbursements. This seems to be the way family medicine is headed. So what will happen to the doc that treats you and your family. The one that knows you interests and what you do for fun. The one that can anticipate your needs? 

What is it exactly thats causing these solo practices to go out of business? High overhead. Treatments now require more technology, employees, and supplies. This leads to high volume practices to make up for the costs, which makes the solo practice unsustainable. New docs to the field want better hours with free weekends. The best place to do this is in a large practice. So there is no one left to take over those practices established by the retiring solo doc. 

So how do we solve this? How do we keep the friendly neighborhood family doc while still allowing for sustainability? An idea that comes to mind is a loosely associated group practice. This group practice will be established on the following conditions:

1. Each physician will operate as an independent practitioner. These physicians will set their own hours, maintain their own patient panel, etc.

2. The physicians share the costs of rent, employees, EMR, etc. For example, they can share a receptionist/phlebotomist and nurse. They can share the cost of EMR. Physicians can now have websites on which patients can make appointments and choose on the length of the appointment. 

By lowering the overhead by sharing costs and employees, the principles that solo docs operate by can be protected. By having multiple physicians working together, they can negotiate better reimbursement rates. They also have the benefits of having peers to consult with and having colleagues to cover for each other on vacation. 

At 3:45 Dave Meslin makes a point that resonated very strongly with me. He put up a slide with the some of the most popular movies of our time and asked what they all had in common. All the heroes in those stories had been chosen by others to become the hero. From this, Meslin understands why most people are hesitant to participate in their local politics. Our culture sends out the wrong message about leadership. 

He follows that by making three points about what a heroic effort is really composed of.

1. A heroic effort is a collective effort.

2. Its imperfect and it isn’t glamorous. It is an ongoing process.

3. Its voluntary. ”If we teach our kids that heroism starts when someone scratches a mark on your forehead, or someone tells you you are part of a prophecy, they are missing the most important characteristic of leadership, which is that it comes from within, its about following your own dreams uninvited, UNINVITED, and working with others to make those dreams come true.”

How do we promote this? One idea that comes to mind is to promote these ideas in the movies, comics, stories, etc. that young people look to. We know that is not the case today because of the movies Meslin listed in that slide like The Matrix, Harry Potter, and The Lion, The Witch, and The Wardrobe. 

Muhammad Yunus was forced into retirement. The politicians in his country, jealous of him and frightened by his influence have forced him out of the bank he started. Even with support from prime ministers, US senators, and fellow Nobel Laureates, Yunus was cast aside. What happens now with the poor people the Grameen Bank supports?

Back in 2008, we elected Barack Obama because we believed in Hope an Change. But we, The American People, were irresponsible. We, against our better judgement, in our immaturity, for some reason, believed that he alone could change the world without our support. We thought we could sit back and he would do all the work. Now no one supports him. Liberals feel he let them down and call him a corporate puppet. Conservatives call him a socialist. And the independents who voted for him have disapproved of his performance. 

Who is to blame? Its us. We have to grow up and realize that no one man can change the world. It takes team work. It takes all of us standing up for what we believe in. The old ways won’t work anymore. We can rely on just one person.

A social business is a business in which the end goal is not a profit but in addressing an issue, it could be a social issue, a need in the community, or even to do something no one has done before. Muhammad Yunnus, a Nobel Peace Prize laureate, explains this idea in great detail. 

Investors who give money to a social business do not do so in hopes of dividends but instead to see that goal or issue to be addressed. For example, if I wished to see better access to healthcare in my community, I would invest in a social business who took that on as its goal. Over a period of time the money invested would be returned, and my dividend would be increased access to care. 

Daniel Pink explains this well in his TEDTalk.

There are four things necessary to get the most out of a person.

0th Law: Pay them enough so they aren’t concerned with money.

1st Law: Allow autonomy. Communicate the job clearly and then let the person do that in their own way.

2nd Law: Provide for mastery. People like to get better at the things they do. They like to see progress in their work.

3rd Law: Serve some greater purpose. Explain to your teammates the goal and how it contributes to the bigger picture. Simon Sinek elaborates this idea in his TEDTalk about leadership and inspiration.

These only work when there is adequate funding to pay the people in the business and that the interests of each member of the business align with the business as a whole. If they are there for themselves, and they see improvement in the cause they are passionate about, their job satisfaction and productivity will be higher than they have ever experienced. 

The challenges we face today won’t be overcome with old techniques. What I believe in, what I think can overcome the challenges of unemployment, job satisfaction, rising costs of college tuitions, the lack of quality, cost effective, affordable healthcare, etc. is social business. 

Just as there are people who wish to make a lot of money, there are people, who with the same intensity, if not more, wish to better their communities. Profit making businesses however, attract much more funds and talent than the nonprofit sector does. Millions of people compromise their dreams to work at a job they do not enjoy, and millions of young people go to college without a goal. I believe there is a mismanagement of human resources in our current society. 

I know that I have lots of ideas that would improve life for millions, and I know that I would be great at starting and running businesses. But I don’t care about profits. I am one of those people who would rather serve the community than be wealthy. I believe there are millions of people who feel the same way I do. However, reality hits and people write that off as unrealistic. They have bills to pay, children to take care of, etc. So they go to school taking on debt, or go to work to pay off that debt. Its like we are enslaved. 

The system stopped serving us long ago. Some where along the way the roles were switched and we started serving the system. I believe we can change this. Social businesses are a means by which people can move in the direction they wish and still contribute. 

Childhood Obesity caused by high fructose corn syrup, sedentary lifestyle, lack of physical education or exercise programs in school, poor food provided by schools, low cost of food with HFCS

Healthcare costs are about to over run the country

90% Dissatisfaction at work place The number of people who wish to live meaningful lives is about six times as high as those who wish to become rich 

Rising Cost of College Education and its irrelevancy Most people cannot get a job in their undergraduate degree and most people are dissatisfied with the job they have. On top of all that they have numerous loans to pay off.

Low performance of public schools

Food industries questionable practices

Climate change and energy crisis There is an abundance of energy in the world yet we are stuck on fossil fuels. 

We sacrificed heart for capitalism In the dog eat dog world of capitalism we sacrificed our investment in each other to focus simply on ourselves

I am looking for people who believe what I believe

I believe that we have the knowledge, information, and research that we need to make the world a better place than it currently is.

I believe we have all the knowledge and direction about people, personality types, social/emotional intelligence, and societies that we can all live harmoniously with each other. 

I believe we have all the knowledge and direction in science to live in a clean and flourishing world.

I believe that when enough people who feel this way move in the same direction the world will too.

“Got treasures in my mind but couldn’t open up my own vault.” - Kanye West

We live(d) in an era called the information age. At the tip of our fingers lay all the knowledge humanity has gained so far. But what good is that knowledge if we don’t learn from it? We still have poverty, war, and hunger. Half the population lives on $2 a day. And climate change is slowly creeping up on us. The issues mankind has faced since the dawn of civilization are still here. They are here because humanity has still yet to achieve its potential. It has still yet to fully realize itself. 

I believe that we have all the knowledge, the skill, and the manpower necessary to fully realize ourselves. So here I will lay out a blueprint, a guide, for how we will accomplish that. 

I am doing this because the world as it is, is not enough. I have met far too many talented and capable people who have lost faith in our world and resigned from their dreams; leaving the world to reflect the desires of a few individuals and not the whole of humanity. There are far too many voices that are not heard and far too many dreams that are shattered.