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Jesus Lehi Garcia
Posted 04-12-2018 14:20
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Hello everyone, wanted to take a moment to introduce myself. I'm Lehi (Like Lè-hi), currently a Geriatric Medicine Fellow.
A little background about me (2 minutes tops, I promise). I'm an IMG from Mexico, did FM in Westchester County and currently Geriatrics in Long Island. I'm also doing a fellowship in Palliative and hospice fellowship in the next academic year. I've been interested in Geri and end of life care since Medical School and I'm grateful I have been able to take charge of my career path choices and I'm heading towards where my passion resides.
Since medical school I have had this idea of having my own practice. I have a strong belief in having a minimalistic approach (like my old attendings did, like starting in a garage or their own kitchen and working their way up from there. This feeling was reinforced during residency and seeing inefficiencies getting bigger as new regulations and requirements come into play. This affecting patient satisfaction with their care and also stressing the hell out of the Physicians that are treated like cargo mules on a hamster wheel (well you get the idea).
I residency I started reading on this community posts and questions in this forum, giving me hope that there is more than the Rat Race in the world of medicine. Now I'm a little over a year from me entering the real world and I'd like to plan ahead on what I need to succeed in setting up my practice. (I like to plan ahead on most aspects of my life so I don't get caught by surprise).
I've been doing home visits with my Geri Fellowship Program for the past year and I came to realize I like Home care (and I'm actually good at it), and it fits perfectly with the Geriatric and Palliative Care I want to provide in the future. I live in Queens and there are very limited services provided for home care, so this would be my nice little niche to start with. Also, there is a big Hispanic population in the area that would allow me to give back to my community. I
Being home care, and if I'm able to target an specific geographical area, I wouldn't require an office as I could do my work on the go. Also I would strive to maintain a minimalistic approach to what I need and work on efficiency. (I liked the Lean Start up book recommended few days ago here, and reminded me of the book "Transforming Health Care : Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience" I read a few years ago before starting residency).
List of thing I would need include:
-Laptop with good security (I'm thinking a chrome book as has very limited phishing/hack attacks risks) along with a cloud based EMR.
-Transportation, Being NYC, transportation is fairly decent and also another incentive to stick to a geographical area, plus I love the flexibility and fresh air).
-Stethoscope, BP cuff, Thermometer, gloves, hand sanitizer, and all the goodies of the little black doctor's bag.
-You can add anything to this list if you think is important.
-I think I would get the Blood Draw certification and carry some tubes with me just in case.
-I still have to write down a checklist of all the administrative things I have to complete prior to launch (LLC, Website, Medicare/Aid applications, and so on) so I can work them out in the next few months.
-Stablish relationships with Social work agencies, wound care, specialists and visiting nurses for referrals and advance care as needed.
My goal is to see 8 patients a day with about 50% of them being Medicare/Aid and rest on cash. I still have to determine cash prices and where to base those from (so if any of you know how I can come up with those prices that would be a great help). Further down the line I'd like to offer a day out of the week as a free clinic for those underserved but I'd have to be able to support myself first.
To finish up this post (sorry if it took more than 2 minutes), I have no Medical school debt, not married, no children. This allows me to think I could set up something close to what I described above as I don't heavy commitments and I can continue living with the salary as a resident for a couple more years if needed.
I believe excellent care can be provided to those that need it the most, the very ill and in the end of life with the right approach and the right resources. So, wish me luck!
Jesus Lehi Garcia M.D.
NYMC at St. Joseph's Medical Center.
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