Matthew Holt has a few posts about Jay Parkinson, MD’s medical practice in Brooklyn, which is cash based and all digital and electronic–electronic medical record, online chats, video chats, emails to patients–totally awesome. I love the practice style.
My main concerns? Two things: he’s stealing all the easy work from people, and while I’ll admit I don’t know much about preventive medicine residencies, how much training does he really have in treating adults, when he did a pediatrics residency?
On the first point: he will only see adults age 18-39. If you look at adult preventive health care guidelines for people 18-39, it’s really mostly blood pressure checks and physical exams, with an occasional cholesterol check and pap smear and STI check for women. After kids, 18-39 year-olds are the healthiest group of people there are. For the most part, their main health problems consist of viral illnesses and substance use. Are there sick 18-39 year-olds, sure, but they’re the vast minority. Bottom line: 18-39 year-olds are, for the most part, incredibly easy to care for. Do they need to be seeing a doctor, sure, but man, low-hanging fruit.
My second concern: adults are not big children. The majority of a pediatrics residency is spent taking care of very sick babes and children. (Or seeing them in clinic and learning all the rashes and viral syndromes that most kids get seen for, the milestones, the vaccines, how to talk to parents, etc.) The closest you come to adults in pediatrics are adolescents that come in for physical exams for school for the most part. But you certainly don’t see adults, besides the occasional 18 year-old who wanders in and hasn’t changed doctors yet. Maybe this isn’t much of an issue, since taking care of these patients is pretty straight-forward, but still, it doesn’t seem like the training fits the job description.