I have a private practice which is about 85% medicaid. I feel the same way about quality vs. quantity. Medicine today has become a numbers game. The only way to make a living is by increasing the number of patients you see.
I am in a somewhat different situation, as I don't have a boss to report to. On the other hand, if I don't see enough patients, I don't make enough money to live on!
I refuse to compromise on the quality of care I give my patients. However, in Pediatrics, not everything has to be done by me! I have learned to delegate a lot. Nearly all bloodwork and throat cultures are done by staff. I have a medical assistant prep the patients for me before I come in (vitals, height and weight, set out equipment needed, etc.). I use an EMR with templates which really speeds up my charting.
I try to balance giving my patients the time they need, and moving quickly. For the most part, it works. Some patients need a lot of time, some are happy to just be seen quickly and be on their way.
Most days I can see between 30 and 40 patients between 10:30 and 6, but I do not have any breaks. Sometimes I return patient calls at night, after my kids are in bed.
I don't make a huge amount of money working this way. I could probably make more money if I treated my patients like "numbers" like some practices in this area do, but I will not do that. I would rather make less and give my patients quality care because that is what I went into medicine for.
good for you! I'm glad that you have made the conscious choice to limit quantity so that you can continue to provide quality care.
Unfortunately my specialty is so expensive to start (the equipment, and if I want to delegate, the cost of a trained staff member) that I can't create my own practice. I did consider the boutique medicine route but after cruching the numbers it just isn't feasible. It's a little late now to switch to primary care, especially since I really love ophthalmology. So I've made some changes to my hours to try to keep my burn-out low and we'll see where it goes.