As a primary care physician practicing in Portland, Oregon, I’ve
experienced firsthand the problems that our health care system
creates for patients and doctors—especially in a traditional
clinic setting.  During a three-and-a-half hour period (a half
day), I’d go straight from visit to visit without checking my
computer to review notes from incoming phone calls, incoming lab
results or patient email messages.  Although each visit was
scheduled to be about 20 minutes long, they’d inevitably take
longer—after seeing ten patients, I’d be running over an hour
behind. Then I’d sit down at my desk to review calls, emails and
lab results, as well as finish visit notes for everyone that I
saw.  By the end of the day, I often felt like I’d been hit by a
truck. And worse than that, I felt like I needed to apologize
constantly for inadequately meeting the needs of patients.  I’m
not the only physician who feels this way: In 2010, a group of
doctors in Philadelphia published a study that described their
work in the New