Brave new attitude improves practice

San Francisco - The complexities of running a practice - employees and a family who depend on the practitioner - sometimes make it easy to get so involved in details that dermatologists can be distracted from the primary reason for entering medicine - that is, the treatment of people.

That's the message from Michael A. Greenberg, M.D., of Grove Village, Ill., at the 64^th Annual Meeting of the American Academy of Dermatology, here.

Refocus on care, compassion

"I had started competing with a new doctor who was business-oriented and media-savvy. I turned my office into a factory and started worrying about the bottom line. I saw over a hundred patients a day - and after two years I turned to my wife and told her I was quitting medicine. I hated it."

Ready to call a practice broker, Dr. Greenberg had a revelation. He suddenly understood that he didn't need to make the most money - he had to go back to caring for patients, and he had to share that message with others.

Now, he not only enjoys his practice, he has found that refocusing was one of the best business moves he ever made.

Success on multiple fronts

"The first return for the doctor who practices like this is a whole lot of satisfaction. You don't get a bunch of angry patients who think you're a jerk; they're more likely to bring you chocolate chip cookies.

"Secondly, the return shows on the bottom line. Care and compassion are the best business practices ever."

Dr. Greenberg says it's similar to free cancer screening clinics dermatologists participate in - they don't make money but they do win respect for the physician.

"For doctors who are interested in the spiritual quest, this is a natural. For doctors who ask what's in it for them, I say it will bring you a whole lot more money. My office is jammed."

Dr. Greenberg's office has two rules.

Dr. Greenberg offers his idea of qualities doctors should develop when trying to restore some humanity to the practice of medicine:

Presence. Be there and listen to people. "You can't be thinking about the next patient, the last patient, your new Mercedes, the fight with your wife - you've got to be there when you're supposed to be."

Compassion. Be willing to feel a patient's pain.

Intimacy. "Medical students laugh when I say that. I tell them, 'No, it doesn't mean sleeping with your patients; it means opening up and being honest about who you are.'"

Take care of yourself first

Care and compassion must start with the doctor, however. Dr. Greenberg stresses that physicians must take care of themselves.

"Are you taking care of yourself? Are you going on vacation? Are you working out? Are you taking care of your family life? If you aren't taking care of you, you can't take care of other people."