Two Weeks In.

On July 1st I unlocked the door to my own practice for the first time. My mother-in-law Kathleen was at the front desk. She's our office manager, and if you call us, she's the one who picks up. We had a handful of patients scheduled and a brand-new EMR that neither of us had ever used with a real patient in the room.

I'll be honest about how that first day went: not great.

I've been using Epic for almost ten years. It's basically the only medical record system I've ever known. So on day one, visits that would normally take me fifteen or twenty minutes were taking an hour. Kathleen and I couldn't figure out how to get patient information loaded into the chart. I had built these nice online intake forms, and patients were actually filling them out, and then we couldn't figure out where they were supposed to go. We were problem-solving in real time, sometimes mid-visit. It was stressful. It was also, weirdly, kind of fun.

What Actually Mattered

Because here's the thing. Once the computer stuff faded into the background and it was just me and a patient talking, everything clicked. That part I know how to do. After months of paperwork, credentialing, contracts, insurance enrollment, and every other unglamorous thing that goes into opening a practice, sitting down with patients again felt like a breath of fresh air. This is what I actually do. Taking care of people, helping them work through addiction, doing counseling, offering the little tidbits that help someone's life get a bit better. I missed it more than I realized.

And the best part of these two weeks, by far, has been the familiar faces. Patients I've taken care of for years — some for four years straight — took the time to find me. They looked up the new office, called, and came in. Nobody made them do that. They did it because our relationship meant something to them, and honestly, that got me.

In this field, the relationship between a patient and their doctor often IS the treatment — or at least the foundation of it. Watching people show up at my door because of that relationship has been the single best feeling of this whole thing.

Things I've Learned in Two Weeks of Private Practice

There is an endless parade of people who want to sell you things. Drug reps, lab reps, reps for things I didn't know had reps. Part of the learning curve is figuring out who actually wants to help you build something and who's just making the rounds. I've been lucky. The people I've chosen to work with have genuinely been rooting for this practice, and that matters more than I expected.

Week two went better. Kathleen got the front desk humming. Patient information started landing in the right spots. I got faster on the new EMR. Some might even say I became almost efficient.

I also got out of the office a bit. I gave a lecture to a family medicine residency program and spent an afternoon with the therapists at a local outpatient substance use program. Teaching residents and working alongside counselors and therapists is a big part of what I want this practice to be about, so both of those days were good ones.

What's Ahead

Now for this coming week: forty patients on the schedule, seventeen on Monday alone. And anyone who works in addiction medicine knows the schedule you start the week with is not the schedule you end it with. Patients call. Crises happen. We make room. That's kind of the whole point of doing it this way. When someone is ready for help, the answer should be "come in," not "we can see you in six weeks."

Has it been stressful? Very. Are we still figuring things out daily? Yes. But I get to build this practice the way I've always envisioned it, and that has been worth every frustrating minute so far.