By John Addyman
Physician Laura Petrescu quit her job with Rochester Regional Health to start her own membership-based practice
Physician Laura Petrescu has become a direct primary care physician, in the mold of the doctors some of us remember from a long time ago — doctors who would sit with you and treat you in an unhurried fashion, someone you called by their first name, almost a respected neighbor with a stethoscope.
She’s Romanian, coming to America with her software-engineer husband Catalin, who had taken a job in Silicon Valley in 2007.
“When Catalin got the job offer, our son was 18 months, and I said, ‘I’ll go with you.’ I had absolutely no desire or plans to leave Romania,” she said. “I had no idea what it takes to be a doctor in America — I had no clue. I said to him, ‘I’m going to be with you, but I’m going to be a doctor there — whatever it takes. I don’t speak English. But I’m going to be a doctor.’”
For almost two years, Petrescu — who was a doctor in her native Romania — worked her way through board and certification exams, and finally got matched for a residency all the way across the country — at Rochester General. The program director, physician Paul Bernstein said she would become a good chief resident.
“He was a wonderful mentor for all of us. He told me I would do a wonderful job and I had to trust him, more than I trust myself.”
Catalin had taken a job in Rochester, too. The Petrescus were ready to settle down here.
“Rochester is very similar to my own hometown, Iasi, [pronounced “YAH-shee”]. The weather is exactly the same — four seasons and snow and beautiful fall. For me, being in Rochester felt a lot like home. Moving to Rochester, I felt at peace. I like the community, there are lots of things to do. It’s a really good place to raise a family and I felt comfortable with my small child. I loved the community at Rochester General where I trained.”
She rose through the ranks, joined the teaching faculty, became chief medical resident and spent a busy 14 years in the Rochester Regional system.
“I worked in patient, outpatient, hospital, surgery, internal medicine — a little bit of everything. At the end of the day, I knew deep down my calling is to be a doctor. I cannot imagine myself doing anything else on the planet.
“But how do you reconcile your time?” she asks. “There are still just 24 hours in a day. How do you manage to put enough time into a career and do a meaningful job and be there for your family and yourself and other things you need to do to be happy?”
Time and substance became big issues for her.
“In primary care you get 15 minutes on the clock to see a patient. Out of those 15 minutes, patients need to check in and check out with the secretary and the nurse, so face-to-face time for the doctor – I have five to seven minutes. That is the reality,” she said.
“Primary care has become the gateway of referrals. You have a headache, you go see the neurologist. You have a foot pain, you go see the foot doctor. Or I give you a pill…a pill for every ill. There is no time to sit down and really listen and come up with a plan that makes sense for the patient. I had 25-27 patients to see in a day. It was like a hamster wheel. There is no quality of care in that. It’s not meaningful to me as a physician to feel rushed like that.
“I’m sure it doesn’t feel good on the patient side to be rushed out the door, get out and get a prescription, and go see a different doctor. It’s a lot of wasted time and energy and money because you go see so many specialists for things a primary care physician can do.”
Petrescu started studying something that has been around for decades — direct primary care — where a doctor charges a monthly subscription or membership fee and accepts a limited number of patients to care for. Petrescu said in today’s healthcare systems, a primary care doc might have 3,000 to 5,000 patients. She feels 300 patients is a much better number to deliver consistent quality care.
“What I’m hoping to offer in this practice is time. I’m not restricted by corporate medicine to have five-minute appointments, and I’m not restricted by insurance companies to tell me what box I need to click on the computer for them to reimburse me. I’m just driven by patient care. There’s no middleman rules or restrictions there. That’s the biggest difference in our primary care. I can take 30 minutes, an hour, two hours. My regular appointments are one hour but I always allow for two hours if that’s necessary to really listen and understand what’s going on with the person. We come up with a plan that really makes sense.”
But the final decision to leave corporate medicine and set up her own shop came about after a visit from fate.
“What really triggered me and helped me make that final decision was surprise! surprise! — getting pregnant before menopause. I had my second child.”
After consulting with three attorneys and getting things ironed out with three accountants, Petrescu opened Athena Direct Primary Care in Pittsford on Jan. 3.
She doesn’t have a waiting room — it’s a lovely “meet and greet area” — because she only sees one person at a time, and it’s usually for an hour. There’s virtually no waiting. She happily schedules her patients in same-day or next-day appointments.
Patients communicate with her by phone, text, email and through telemedicine video. She is always on call.
In August, a patient texted her from a conference he was attending in Tennessee: he thought he was having a stroke.
“I got on the phone right away to see what was going on,” she related. “I was able to coordinate care and help him and walked him through what he needed to do to get back home safe and sound. I saved him a ton of money and unnecessary stuff that would have otherwise happened. A physician who did not know him or trust him would have sent him to an emergency room. But me knowing him, I managed to get him back to Rochester safe and he was beyond happy.
“This is the kind of service that makes a difference in someone’s life,” she said.