What\’s Up, Duck?

Writer’s block.

It seems that I have been suffering from a prolonged case of writer’s block. It’s not that I haven’t been writing (I write regularly for several publications); it’s just that I haven’t been able to write anything worthy of putting up on the blog. I guess it felt like I was just writing about my practice all the time (which has consumed much of my energy), and that gets a little dull.

So how to pull myself out of my writer’s block? Write about or rupturing healthcare system? Write about the abuse of doctors at the hands of our insurance (and government) overlords? Write about the insanity of politics and the mutilation of common sense? Write about the royals? About Cheetos? About mutant ducks?

Whoa. Mutant ducks. Hmmm. Maybe I should start writing again. I wonder if they eat Cheetos.


And people say there is no God??

Before getting to the important subjects, however, I think I will reintroduce myself and give an update about the world of Rob. Maybe I can knock some of the rust off of the writing gears and get things moving again.

My Practice

My direct care practice continues to be successful. We just celebrated our 6th anniversary (traditionally known as the Taco Anniversary). Yes, despite being run by a doctor, my practice has succeeded! Amazing. We are up to 800 patients total, and continue to grow slowly. Despite being one of the larger single-provider direct care practices, I’m not close to overwhelmed with work. My days are steady, with an average of 8-10 patients per day. I still take Monday mornings off and close early on Friday (3 PM). I get home around 5:30 on most days and don’t have much work to do when I get home. My life is great.

I am as strong of a believer in the practice model as ever. My patients are happy (very few patients cancelling their monthly memberships) and the care I’m giving is far better than I ever could give in the brutal and patient-harming atmosphere of fee-for-service medicine. There really is no comparison.

Jenn and Jamie continue working faithfully for me (beloved by my patients) and bail out my sorry butt with great regularity. They are happy too, and get really angry when I talk about retirement any time before age 90. I’m lucky to have them. Very lucky.

New Addition


I have no idea. Don’t ask.

The big recent change is the addition of a new doctor to my office. Dr. Ed joined me and the troops this January, but not as an employee of the practice. He is simply using our office as his launch pad to start his own direct care practice. He’s paying half of my overhead, is surrounded by folks who know how to do this kind of practice, and has gotten some of the folks who don’t want to wait 2 months before getting a new patient appointment with me. He has already exceeded 100 patients, which is fabulous growth. It’s truly a win/win.

What I really like is to see how delighted he is to be working in this practice. It’s like someone telling you your kids are fabulous, your tacos are tasty, or your feet smell like chrysanthemums. Maybe not that last one…I got carried away. Regardless, he tells me how happy he is on a daily basis, being able to “practice the kind of medicine I became a doctor to be.”

My feet do smell pretty good, by the way.


Additionally, there’s a third direct care practice in town, run by a husband and wife team of really talented physician assistants. The three practices are teaming together to form a network with which we can contract with small to medium sized businesses to offer them an affordable option for care. This is called the Welcome Health Network, and will be available to local businesses very soon.

We hope to also use this network to collaborate on other projects to give better patient-centered care, such as lab services, radiology, medication dispensing, and access to cheaper ancillary services. It’s a work in progress, so I can’t say exactly what will come of it, but I am very excited to have other hands moving things forward in my world.


What about my personal life? If you are reading this, you are probably a pathologically loyal reader, a stalker, or my mom. If the last one, this next stuff shouldn’t surprise you. Here’s a run-down of my life:


Artist’s depiction of my feet

  • I went through a divorce two years ago, but have maintained a decent relationship with my ex. We don’t hate each other; It just didn’t work out.

  • My kids are doing well, with my youngest spending a large amount of my money in a private university close by.

  • I lost nearly 50 lbs over the past 4 years, doing it the boring way: exercise and portion control. I ran a 10K a couple of weeks ago (despite my 50-something body) and might aim higher later this year.

  • Did I mention that my feet have a floral odor to them?

  • Overall I am happy with my life where it’s at right now. I am exceedingly blessed.

Anyway, it does feel good to pound out a blog post and I hope this gets my writing started again. There are topics to be covered, words to be spoken, secrets to be revealed, foes to be vanquished, ducks to be mutated, Cheetos to be eaten.


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