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Why I Became A Concierge Doctor

Usually I write about medical issues, but I figure no one needs more information about the pandemic from me.  No other topic leaps to mind.  I thought that I’d share a more personal experience that may have some resonance with readership of the Feather Sound News. 

I made mention in an earlier article that I had previously been an emergency room physician.  That has been the last 19 years of my life.  It is shift work.  One clocks in and sets about attending to the tummy aches, toothaches, heart attacks and strokes while trying to keep to a minimum the number of people who die from heart attacks, strokes or the occasional sneaky tummy ache.  It’s chaotic stressful work, but not without its rewards.  The occasional life saved, difficult diagnosis made or the gratitude of a family for easing the passage of a loved one make it worthwhile.  The shift ends and one goes home.  Such is the life.

In the past few years, hospital administrators have required ER physicians to act in ways that we feel to be detrimental for patients. Many physicians feel trapped and simply resign themselves to their situation and making the best of it.  As for myself, being trained and certified in Internal medicine as well, I had options.

When I went into medical school, I fantasized about a practice like the old country doctor.  Where he knew his patients by name, made house calls as needed and occasionally took chickens as payment.  Things change with time and reality trumps fantasy; besides I have no place to keep chickens. After 9 years of med school and residency, Emergency medicine gave us a good life.  Now, however, at nearly 50 years old, it was time for a change.

I know it has been a long way getting to it, but herein lies the point.  How does one start over?  My wife, a physical therapist, and I had talked for years about opening an office together.  After some consideration and research and consultation with lawyers and other doctors who have similar practices, we figured out that it could be done.  There was a way toward that vision of a practice that inspired me to get into medicine in the first place.  Despite the pressures to leave Emergency medicine, It was not an easy decision to go out on my own.

For my entire career up to this point, the patients just magically came to the ER.  I would just show up, do my job and go home and collect a paycheck.  Of course, that is oversimplified but it was safe and predictable.  For the new practice, that security was gone. 

Ambulances don’t bring patients to a doctor’s office.  I need to give them a reason to find me.  Being someone’s primary doctor is ongoing.  The last time I was responsible for someone outside of an emergency room was 20 years ago.  Back to class and the books for me.  Then there are all of the procedural and legal issues of running a business that I never had to deal with before.  Then there was the building purchase and remodel.  It was overwhelming!

It is 10 months in now and the majority of that is behind me.  Most of the fear is gone or at least I’ve gone numb to it.  Out of all of the feelings to deal with, leaving my comfort zone was the hardest to face.  I understand that is a common thing which is the reason that I am telling this story.  If a reader of this is thinking that they need to change the course of their career or life, I would hope that this gives them some courage.  Fear of change should not keep you from doing something that you know deep down that you have to do.  Math and logic are necessary aspects of any major decision but emotions need to recognized and dealt with as well.

I am now seeing patients the way I wanted in the beginning.  I still have no place to put chickens.  They say it takes about three years to get a business up and running, we’re doing OK.  Most importantly, I’m happy.  It was worth it.

Dr. Matthew Kramp, DO

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