In the health care loop
Answers in Practice
By Victoria Houghton, Managing Editor, July 1, 2023
DermWorld: Tell us about you and your dermatology office — how long have you worked with MAPMG, what do you specialize in, how large is your office (personnel-wise)?
Dr. Khoury: I have been with MAPMG for almost eight years. My practice focuses on all aspects of dermatology — medical, surgical, and cosmetic. In our Northern Virginia service area, we have nine dermatologists across four offices, and 13 more in our D.C., southern Maryland, and Baltimore regions.
DermWorld: Why did you decide to work in a single-payer model health care system? What drew you to this model?
Dr. Khoury: The wonderful thing about working in this model is that many of the things that detract from the joy of patient care are functionally eliminated from our practice life. We don’t worry about managing prior authorizations, coding/billing, or difficulties coordinating with other specialties. My colleagues are outstanding clinicians and people with a shared mission of delivering the highest quality care in an efficient and enjoyable way.
DermWorld: Tell us about a typical day at MAPMG — do you work set hours? How many patients do you typically see?
Dr. Khoury: Like many MAPMG physicians, I’m a working parent. We attract and retain top talent by ensuring that physicians can thrive in all aspects of life, and a big part of that is flexibility. I generally see patients four days per week, eight hours per day, and see on average one patient every 15 minutes. Of course, there is some variability when you account for procedures and administrative responsibilities, but that is the general cadence of my week.
DermWorld: Tell us about some of the administrative tasks that you manage. What type, if any, support do you receive?
Dr. Khoury: Our support staff is incredible. Each specialty has a clinical operations manager who is our primary partner in ensuring our staffing needs are met and that our days flow smoothly. We all document in our systemwide integrated EHR and do not require prior authorizations or quality reporting from physicians.
DermWorld: Tell us about collaboration among other specialties/physicians within the MAPMG system. How often do you collaborate with different specialists? Do you find it beneficial to all be under the same umbrella — why or why not?
Dr. Khoury: If you twisted my arm, I would say this is the single biggest jewel in the crown! We collaborate very frequently, and it is such a wonderful experience for physicians and patients. The ease of communication — from our shared EHR to our secure iPhones with texting — allows us to stay in close touch and streamline care plans and curbside other MAPMG physicians, which is a real patient-pleaser. I know everything my colleagues have done, and vice versa, before the patient even walks through my door. It is also a lot of fun to get to know and work with such an exceptional group of physicians on a regular basis.
DermWorld: Tell us about your work-life balance.
Dr. Khoury: Balance is a tricky concept, isn’t it? It’s so dynamic! There are times when work pulls the tug-of-war rope a bit tighter, and the same goes with home life. I am fortunate that my husband is a true partner, engaged in our children’s activities and keeping the family circus under (moderate!) control, and am equally lucky that my colleagues and I all watch over each other and step in to fill gaps as needed. There are times when I think I have it all figured out, then there are times it’s a hot mess, but that’s life! Another cool thing we offer at MAPMG is our region-wide robust teledermatology service. This allows the doc of the day to read from home about once a month, which can be a nice change of pace.
DermWorld: Are there any disadvantages of working in a single-payer health care system?
Dr. Khoury: Because our network is so extensive and our physicians so exceptional, I honestly do not consider this to be a true “disadvantage,” but in a successful integrated model like ours, access to in-network physicians and services are unbeatable such that when there is a rare situation where the medically needed service is not internally available, the external service requires an approved referral and all the challenges that exist with third-party payer systems. It’s easy to take for granted (or get accustomed to) the simplicity and purity of clinical practice in our mid-Atlantic health care delivery system. A single-payer system, when done right, is good for the patients and the doctors.
DermWorld: What do you appreciate the most about working in a single-payer health care system?
Dr. Khoury: Our shared mission creates a collaborative, cooperative, never competitive atmosphere. We are all working together with a shared vision of creating a model for the delivery of exceptional care in a sustainable way. We are prevention-focused and patient-centered by design, and it creates a really lovely space to build not just a practice, but a career.
From that stem grows a lot of work families! My brother is a head and neck surgeon here and his partner is a retina specialist with us as well. My children’s pediatrician and her husband are both MAPMG physicians. We all take care of each other’ loved ones, which makes it easy to recommend as a great place to work.
Randa Khoury, MD, FAAD, is a dermatologist with The Mid-Atlantic Permanente Medical Group. She practices in Falls Church and Springfield, Virginia.
Your Dermatologist Knows
Learn more about how the AAD is engaging the public on questions about their health and wellness, while putting dermatologists in the foreground.
