Re: In Praise of IMP

[Guest guest]

wheW!!!to think that I roomed with her some years ago at an IMP camp!To: From: jnantonucci@...Date: Fri, 4 May 2012 10:00:49 -0400Subject: Re: In Praise of IMP

wow Go Lonna!!

awesome!!!

Moitri Chowdhury Savard, MD

http://www.queenswesthealth.com

The information contained in this message is confidential, may containprotected health information, may be legally privileged and is thusprotected from disclosure. It is intended solely for the use of the

addressee. If you are not the intended recipient, or an employee oragent responsible for delivering this message to the intendedrecipient, you are hereby notified that any disclosure, copying orsaving of this communication, or any action taken or omitted to be

taken in reliance on it, is strictly prohibited and may be unlawful. Ifyou have received this communication in error, please notify usimmediately by replying to the message and deleting it from yourcomputer. Thank you.

To: " " < >

Sent: Friday, May 4, 2012 9:59 AMSubject: In Praise of IMP

4 years ago I referred a patient across country to Dr. Lonna Larsh and her IMP practice in Santa Cruz, CA. http://wholefamilymd.com/3001.html

She was gracious enough to accept this lady with major problems site unseen.

The patient had multiple chronic medical illnesses and was previously being taken care of by a cadre of highly trained specialists at UCSF.

Her daughter was flying from Dubai back to quarterly appointments at the tertiary care center.

Only problem was, she wasn't getting better.

Enter Dr. Larsh and fast forward 4 years.

Today I received a thank you note from the patient's daughter. The patient has lost 150 lbs. Diabetes is under control. She is ambulatory and no longer confined to a motorized chair. She danced for the first time in 20 years. Now she wants to hike at Yosemite for the first time since 1980.

"My mother truly needed something our healthcare system doesn't make readily available - a trusted doctor she can go to for anything."

Dr. Larsh and the rest of the IMPs giving this kind of care, you rock.

Ben Brewer M.D.

-- MD ph fax

[Guest guest]

Nice job

Subject: In Praise of IMPTo: " " < >Date: Friday, May 4, 2012, 9:59 AM

4 years ago I referred a patient across country to Dr. Lonna Larsh and her IMP practice in Santa Cruz, CA. http://wholefamilymd.com/3001.html

She was gracious enough to accept this lady with major problems site unseen.

The patient had multiple chronic medical illnesses and was previously being taken care of by a cadre of highly trained specialists at UCSF.

Her daughter was flying from Dubai back to quarterly appointments at the tertiary care center.

Only problem was, she wasn't getting better.

Enter Dr. Larsh and fast forward 4 years.

Today I received a thank you note from the patient's daughter. The patient has lost 150 lbs. Diabetes is under control. She is ambulatory and no longer confined to a motorized chair. She danced for the first time in 20 years. Now she wants to hike at Yosemite for the first time since 1980.

"My mother truly needed something our healthcare system doesn't make readily available - a trusted doctor she can go to for anything."

Dr. Larsh and the rest of the IMPs giving this kind of care, you rock.

Ben Brewer M.D.

[Guest guest]

Nice Idea! Does anyone object to us forwarding this to our local representatives? To: Sent: Friday, May 4, 2012 1:19 PM Subject: in praise of IMP

Thanks for sharing!

Now how many of us will forward that to policymakers/congresspeople or the press?

"We will bankrupt ourselves in the vain search for absolute security." -Dwight D. Eisenhower

zell, DO, MPH.

[Guest guest]

AMAZING!  Lonna, how do you do this?  Share your secret, please!

Eads, MD

Pinnacle Family Medicine

Colorado Springs, CO

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On Behalf Of Ben Brewer

Sent: Friday, May 04, 2012 7:59 AM

To:

Subject: In Praise of IMP

4 years ago I referred a patient across country to Dr. Lonna Larsh

and her IMP practice in Santa Cruz, CA. http://wholefamilymd.com/3001.html

She was gracious enough to accept this lady with major problems

site unseen.

The patient had multiple chronic medical illnesses and was

previously being taken care of by a cadre of highly trained specialists at

UCSF.

Her daughter was flying from Dubai back to quarterly appointments

at the tertiary care center.

Only problem was, she wasn't getting better.

Enter Dr. Larsh and fast forward 4 years.

Today I received a thank you note from the patient's

daughter. The patient has lost 150 lbs. Diabetes is under

control. She is ambulatory and no longer confined to a motorized

chair. She danced for the first time in 20 years. Now she wants to

hike at Yosemite for the first time since 1980.

" My mother truly needed something our healthcare system

doesn't make readily available - a trusted doctor she can go to for

anything. "

Dr. Larsh and the rest of the IMPs giving this kind of care, you

rock.

Ben Brewer M.D.

[Guest guest]

I don't mind. How about Ben? Lonna To: " " < > Sent: Friday, May 4, 2012 10:35 AM Subject: Re: in praise of IMP

Nice Idea! Does anyone object to us forwarding this to our local representatives? To: Sent: Friday, May 4, 2012 1:19 PM Subject: in praise of IMP

Thanks for sharing!

Now how many of us will forward that to policymakers/congresspeople or the press?

"We will bankrupt ourselves in the vain search for absolute security." -Dwight D. Eisenhower

zell, DO, MPH.

[Guest guest]

So good to hear from you Lonna!

You do need to charge more for your fabulous work…  Hang in

there.

Eads, MD

Pinnacle Family Medicine

Colorado Springs, CO

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On Behalf Of Lonna Larsh

Sent: Sunday, May 06, 2012 2:11 PM

To:

Subject: Re: In Praise of IMP

Hi all,

Long time

no contact! Thank you, Sharon for forwarding this to me. I don't

check in on the listserve very often anymore. I just got too busy and too

far behind on messages. But I do miss you all!

It was

really a thrill to see Ben's message about the patient that he so graciously

referred to me, but I'm not doing anything that we don't do every single

day with all our patients. Some of you may have guessed my trick with

this particular patient, and the rest could guess if given a minute....

Loss of 100# in 2 1/2 years, dramatic improvement in diabetes, pain,

mobility... yes, she had bariatric surgery (and didn't tell her daughter or

anyone else). I didn't perform the surgery, but I do see her every couple

of months and spend an hour each visit listening to her and coordinating all

her labs and specialty visits. This has become much easier in the last 2

1/2 years as she has become healthier and more active.

Taking

care of patients is the easy part. The hard part remains making a

living. It's been almost 5 years in (solo/solo) practice and I am pretty

sure most people would have thrown in the towel long ago. What really

keeps me going is knowing deep in my bones I could not go back to my former

life in the big multispecialty practice I was in. It was much more

lucrative, but I was very unhappy. I am now happy, and that's worth a

lot.

Probably

most people on the listserve now don't know me anymore. Here's a short

bio. I left my big practice job in 2007 after working there for 13 years,

doing full spectrum FB including OB for the first 10 of them. I have a

solo/solo cash practice. My office is probably 250 square ft in a suite

with acupuncturists, chiropractors, a naturopath, counselors, a rolfer, an

astrologer and a couple of people who do plant spirit medicine (This is Santa Cruz, after all). I am doing more and more

functional medicine, but still do primarily regular family medicine. I

stopped doing hospital medicine a year ago when I lost my hospital privileges

because I didn't have enough patients in the hospital to keep them. Now I just

use the hospitalists when one of my patients needs it, which isn't often. It

does make it a lot easier to go out of town. I use Amazing Charts, but am

trying to switch over to Hello Health so I can have a secure patient

portal. I just haven't had time to make the transition yet. I use regular

email extensively, which my patients don't seem to mind, but I am slightly

uncomfortable with it. I see 15-20 patients in an average week. I

usually work M-Th, but am in the office almost every day doing paperwork.

I see a patient on one of my off days (F, S, S) probably twice a month.

Patients have full access to me via cell phone, etc but they never abuse

it. I rarely get called in the middle of the night. In fact, I'm not sure

I have ever been called in the middle of the night since turning in my pager 5

years ago.

The main

reason I don't make enough money is I don't charge enough for my office

visits. New patient visits are $200 and they are usually 1 1/2 hours

(though sometimes longer). Follow up visits are usually $95 and they are

usually an hour. If the visit is very simple and quick (30 min or less,

no new rx), I charge $75. I don't charge more because I am too

disorganized at present. It is something I've been meaning to do for

months. My other problem is that I need some office help - ordering,

cleaning, scanning, faxing, that sort of thing. When I get busy, seeing

~20 pts a week, I generate more paperwork than I can keep up with. So I

need to charge more and get more help so that I can see more patients without going

insane. My current office doesn't really have anywhere for a staff person

to work while I am here, so I may be moving in a year when my lease is up. I

love my office otherwise. I have a huge window with a view of hills and

trees, on the second floor so I can keep the drapes open. Parking is

great. My suite mates are lovely, even if I don't exactly understand what they

do.

So that's

what I've been doing the last couple of years! You guys are all doing

awesome work. I'm proud to be a part of the IMP movement. I'll try

to keep in better touch.

Lonna

Larsh, MD

555

Soquel Ave, Ste 260A

Santa

Cruz, CA 95062

www.wholefamilymd.com

facebook:

https://www.facebook.com/pages/Lonna-Larsh-Holistic-Family-Doctor/135778399769444

twitter:

@wholefammd

From:

Eads

To:

Sent: Friday, May 4, 2012 8:53 PM

Subject: RE: In Praise of IMP

AMAZING! Lonna, how do you do this? Share your

secret, please!

Eads, MD

Pinnacle

Family Medicine

Colorado

Springs, CO

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On Behalf Of Ben Brewer

Sent: Friday, May 04, 2012 7:59 AM

To:

Subject: In Praise of IMP

4 years

ago I referred a patient across country to Dr. Lonna Larsh and her IMP practice

in Santa Cruz, CA. http://wholefamilymd.com/3001.html

She was

gracious enough to accept this lady with major problems site unseen.

The

patient had multiple chronic medical illnesses and was previously being taken

care of by a cadre of highly trained specialists at UCSF.

Her

daughter was flying from Dubai back to quarterly appointments at the tertiary

care center.

Only

problem was, she wasn't getting better.

Enter Dr.

Larsh and fast forward 4 years.

Today I

received a thank you note from the patient's daughter. The patient has

lost 150 lbs. Diabetes is under control. She is ambulatory

and no longer confined to a motorized chair. She danced for the first

time in 20 years. Now she wants to hike at Yosemite for the first time

since 1980.

" My

mother truly needed something our healthcare system doesn't make readily

available - a trusted doctor she can go to for anything. "

Dr. Larsh

and the rest of the IMPs giving this kind of care, you rock.

Ben

Brewer M.D.