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Medicine happens in a little room with two people in it.

One of them is nervous; the other is puzzled.  Together they work it out.

No matter how far the check travels, no matter the number of names on the door, it comes down to a patient and a doctor.  First they ask, “What?”  Then they ask, “So what?”  And then they ask, “Now what?”  Then they decide.

Medical groups have grown into systems.  Payers have become more powerful.  Regulators require a greater level of activity. But through it all one thing has remained: a conversation between two people, one to one, figuring out what to do next.

This blog is a resource for physicians who’ve decided to put up with the hassles of running a practice because clinical autonomy is paramount.  The decisions they make with their patients should be the determining factors of treatment.  That’s why they became doctors.