Dr. Rob Lamberts is an entertaining and informative writer who has been chronicling his departure from a traditional practice where his time was increasingly spent with billing codes, rather than patients. In his latest installment, he describes how well it's working. It feels dangerous to write this, but…my practice seems to be working. I am now running and hiding from lightning bolts, meteors, or stray arrows shot in the air by a Scottish soldier. I am also expecting a raid on my office by the IRS, CDC, and BBC tomorrow morning. I don’t know why I wrote that. Knowing Rob, I'm not surprised that it's working. It's well planned/earned. He goes on... But as afraid as I am to admit it, the thing that was once just a good idea is now actually growing and improving. We are up to about 300 patients (with a big infusion when a local TV network did a story on my practice) and have enough money to pay bills without a visit from uncle bouncy. While we’ve started to discuss when we will hire another staff person (probably a nurse), neither me nor my nurse Jamie (may her name be ever blessed) feel overwhelmed at this point. We can handle this volume, which speaks well for the future when we actually have a fully-working system. Slowly, but surely, a movement is rising that has growing momentum. I've written about it in the pieces below. The Marcus Welby/Steve Jobs Solution to the Medicaid-driven State & County Budget Crisis The Hot Spotters Sequel: Population Health Heroes IBM Unleashes "Primary Care Spring" "David Clause" in Obamacare Ready to Slay the Healthcare Cost Beast Health Insurance's $4.4 Billion Bunker Buster Nonetheless, there are always going to be critics. Some even think it's not right (some even calling it unethical) to do what he's doing. Let me share a story one other Direct Primary Care doctor told me about why he shifted away from a 7-minute "productivity" driven, volume-based, referral-generating model. He's now free to practice medicine the way he was trained rather than a "system" our distorted reimbursement model has created. That "system" is best described as a Gordian Knot designed by Rube Goldberg. Unfortunately, doing some minor tweaks to it won't get the job done. As Dr. Rushika Fernandopulle says, "You can't put wings on cars and call them airplanes. You need to rebuild the model from the ground up."