What now—move? merge? retire? stay put?

Abstract

Most everyone is well versed about what's happening in Washington and probably in his or her own state capital regarding healthcare refonn, but what's happening at the grassroots level—with docs in the trenches? Just how has all the tunnoil affected you, your practice, your patients, and your future plans? The answers are surely as varied as the number of physicians reading these words. We interviewed four physicians from different areas and practice settings to get their answers and impressions. Participants were Barton J. Romanek, MD, of Lockhart, Texas; Timothy S. Komoto, MD, of Minneapolis; Dominic B. Brune, MD, of Zanesville, Ohio; and Philip P. Bonanni, MD, of Rochester, New York.

Additional information

Notes on contributors

Barton J. Romanek

Barton J. Romanek, MD Dr Romanek is in solo family practice in Lockhart, Texas. He looks at healthcare reform from the vantage point of someone who was part of the National Health Service in Canada and then chose to move to the United States to escape a system that did not fit his view of how medicine should be practiced. He laments the fact that he is seeing things in US medicine that resemble those that drove him from Canada. In his words, “I'm running out of countries!”

Timothy S. Komoto

Timothy S. Komoto, MD Dr Komoto, a family physician, joined the 17-member Bloomington Lake Clinic, Minneapolis, when he couldn't make ends meet anymore in a small urban practice with a large Medicare and Medicaid population. He finds the new setting quite satisfying and says, “Recognizing that things are never going to be the way they were, this is the best of the options I had.” He is active in the Minnesota Academy of Family Physicians, currently serving as chairman of the board of directors, and has also affiliated with several physician-driven organizations.

Dominic B. Brune

Dominic B. Brune, MD Dr Brune has been in solo family practice for 32 years in Zanesville, Ohio. As a physician nearing retirement, he has found ways to deal with changes in the industry for the short term but admits that if he were at a different stage of his medical career, he'd be worried about the future. As it is, “If it gets too bad, I'll quit,” he says.

Philip P. Bonanni

Philip P. Bonanni, MD Dr Bonanni practices internal medicine in Rochester, New York, an area that he claims has “done the job” of reform on its own. Although he is actually in solo practice, he shares office space with three other solo practitioners who also share office staff and call coverage (“a little bit of a group practice,” as he describes it). He is also clinical professor of medicine at the University of Rochester School of Medicine and Dentistry and past president of the Monroe County (New York) Medical Society.