As I suggest in my blog introduction, I practice in a more rural setting than most. Vermont only has approximately 600K people and most live in just a few larger cities. The rest are spread out into the surrounding, rural towns. Our practice encounters challenges everyday in serving our patients well and yet running an efficient business. For example, we do house calls if needed and the drive can be to a town 30-40 minutes away. Prosthetic patients can be very challenging in this situation. You have to be prepared for a prosthetic fitting or adjustment if going all the way to someone’s house, and yet you know you have limits on how much you can without a lab and certain tools.

A recent frustration occurred with just such a patient: A female bilateral below the knee amputee who lives in a rural town. She cannot drive and has no support system by way of friends or family. She needs to be able to come to the office for specific modifications I cannot do at her house and yet she continues to cancel appointments as her rides fall through. Many other options have been exhausted for her and sometimes I want to drive myself to get her for an appointment with me. Is this efficient, though? Do I have the time to spend an entire day on only one patient? Does this equal excellent customer service and helping those in need or does this represent poor business practice? I don’t have the answers to these questions…yet. For now I am waiting on her to reschedule and contemplating our ride together if it comes to that.