For Pediatrician Dr. Susan Kressly, It’s Equal Parts Patients and Policy
Dr. Susan Kressly started her own practice in 2004 to give her patients what they need.
“Dr. Susan Kressly, a successful pediatrician and health policy advocate, drew her first battle line over bedtime at age 4. But she was not looking to challenge the status quo when she joined her first pediatric practice in 1990.
The newly minted MD was welcomed as the fourth member of a four-doctor group in suburban Philadelphia. She took to the office immediately, appreciating its small town feel and the easy rapport doctors had with their patients.
“It was a well-balanced practice,” Dr. Kressly said. “One of the doctors was my age, and the older pediatrician became a mentor who taught me about relating to families and doing what’s right for the patient.”
But when the practice grew — then acquiesced to the HMO-dominated environment of the 1990s without a plan to make it work — Dr. Kressly decided to blaze her own trail.
“They sold to a health care system with the philosophy of ‘see more patients, make more money,’” Dr. Kressly said. “We were in a capitated market and that doesn’t work, but none of the doctors had the stomach to challenge it. They became complacent; I did the opposite. ”
Dr. Kressly broke with the group and started her own practice in 2004, assuming as little financial risk as possible. She adopted an EHR, hired two nurses to cover clinical and staffing duties, and doubled as the office janitor for the first two years.
The practice was also an early purveyor of social media, providing a web site and patient portal through which patients could find information on their own. This cut down on administrative phone calls, keeping staffing lean and freeing nurses to deal with more critical patient issues.
“I knew I never again wanted to apologize for not giving patients what they need, so I kept it very realistic,” Dr. Kressly said.
Generally, pediatricians are driven, not by the desire to get rich quick, but by the impact they have on medical care. For Dr. Kressly, this impact is made not only in the office, but in board rooms and plenary sessions, where advocacy can have a wide-ranging effect on state and national health care.
Dr. Kressly is president of the AAP’s Pennsylvania Chapter. She is also a member of the Academy’s Section on Administration and Practice Management (SOAPM), Council on Clinical Information Technology, the Quality Improvement Innovation Network, and Pediatric Research in the Office Setting. And since 2010, she has served as Medical Director for Office Practicum, a provider of EHR software for pediatric practices.
“If I can talk to the governor in Harrisburg and change the way he thinks about a bill he’s trying to pass, that’s as important to me as when I sit on the floor, building a tower of blocks with a patient, or when I get a call from a teenager who needs advice.”
It is at leadership meetings, said Dr. Kressly, where she uses her “dominant advocacy gene” to advance an issue.
“You’ve got three kinds of people at these meetings,” Dr. Kressly said. “You’ve got the neutral chair stuffers who absorb and occasionally contribute. You’ve got a group of negative people who use meetings as a forum to complain. And you’ve got the leaders, who motivate the chair stuffer to do more and convince the negatives to strategize a collaborative fix.”
Dr. Kressly, in addition to advocating for better patient outcomes, is keen in her support of physician education.
Last fall, at the AAP’s National Conference & Exhibit, Dr. Kressly had the ear of residents who attended her presentation on how to thrive in a small practice. She said she was disturbed to learn that the residents felt discouraged from going into private practice by faculty and program directors who view hospital employment as the better alternative.
Recent surveys conducted by physician and hospital organizations, and national recruiting firms indicate that between one-half and two-thirds of current physician practice opportunities or searches are for employed positions. Also, the number of physicians employed by hospitals grew by 34 percent between 2000 and 2010.
A recent survey conducted by Jackson Healthcare, a staffing firm that also conducts research on physician practice and other industry trends, found that hospital-employed physicians increased from 20 percent to 26 percent between 2012 and 2013.
Dr. Kressly hopes to spotlight the issue at the AAP’s next Annual Leadership Forum.
“I can only influence where I’ve been able to penetrate,” says Dr. Kressly. “I’ve learned that having someone’s ear may at least give me the voice.”
Meanwhile, Dr. Kressly’s practice continues to thrive. Her leadership commitments continue to increase and demand more of her time. And while she admits to pondering her limits now and again, giving up on either role is not an option.
“If I can talk to the governor in Harrisburg and change the way he thinks about a bill he’s trying to pass, that’s as important to me as when I sit on the floor, building a tower of blocks with a patient, or when I get a call from a teenager who needs advice,” said Dr. Kressly.
“I get satisfaction from both.”