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Carla Gibson FNP


Carla is a long time Missoula resident. As a Family Nurse Practitioner practicing in an 'Ideal Medical Practice' model, she provides

primary care to a smaller patient panel than most providers.  An 'Ideal Medical Practice' puts the patient at the center of the care. 


Examples of how this is put into practice include:

  • Online scheduling:  you can get online at 10 pm or anytime on a weekend to schedule your visit.  You decide how much time you need with me. And you don't have to tell a scheduler why you want to come in!

  • Email & Secure Portal communication:  have a quick question like 'When was my last annual exam?' or 'What was my last cholesterol?'....  I'll answer by email or via the secure patient portal! 

  • Virtual visits:  when appropriate for established patients, we can do some visits by email or phone.  Examples are short interval follow-up visits for some medications like anti-depressants, blood pressure, hormones, or cholesterol medications; or explanations of diagnostic tests or lab tests.  This saves you time.  Your insurance may, or may not, pay.  (See the Virtual Visits Page for more information and how to find out if these visits are covered.)

  • 24-7 Access:  From 2004 through to the present, I have provided 100% 24-7 access to my patients.  Well, maybe the cellphone battery ran out a couple of times... but that was never for long.  In the future, I am planning to have an occasional vacation without carrying a cell phone, but will have call coverage for those rare times. Otherwise, unlike other practices, when you call after hours for an urgent need, you get me....not someone you don't know and who doesn't know you.   Of course, because you also have access by email and same day appointments, most patients never need to call after hours!

  • Solo Provider:  Solo really means solo... no staff.  That means there are no layers of support staff or hoops to jump through to get to me.  What most people want from their provider is their time and expertise... essentially, access to the provider's brain.  My practice eliminates the layers so you have direct access.  This requires that I see fewer patients in order to provide that level of service, but it also means I can provide more time for each person. 

    It is a delicate balancing act to manage all the behind the scenes work for each patient visit.  Occasionally we might stumble, but most of the time, it works wonderfully.  It is only possible through the use of technology such as cell phones, internet phone systems, an electronic medical record, email/portal, and such.  Sometimes it may mean that you do a little leg work on your own such as calling to schedule with a specialist to whom you've been referred, but most folks like to do that on their own anyway!

  • Longer visits/Integrative Focus:  It takes time to tell your story.  If you are in for anything other than the simplest of illnesses like a cold or earache, there is usually background history or information that is very important in creating a treatment plan.  Sure, I could cut you short and hand over a prescription in a 15-20 minute visit, but that doesn't bring either of us satisfaction.  Prescriptions are seldom the whole answer and sometimes, are not the answer at all.  Many typical practices are like prescription vending machines - I don't think this is the best approach.  Our visits will generally be more in-depth and focus on working to understand the core of the problem to improve your well-being.

    I believe it is imperative to work as a team with you, and with specialty physicians when needed. Some patients consult me for some services and maintain their primary care elsewhere. When that is the case, I try to keep the primary care provider "in the loop" with your permission.



Background

I am originally from Florida but, since arriving in Missoula in 1985, have always felt that Montana is my real home.  I have an extensive background in hospital nursing in emergency care, critical care and cardiac care.  I completed my graduate studies at Gonzaga University in 1996 and was credentialed the same year as a Family Nurse Practitioner.

Since then, I have provided the full range of family practice services-initially in Superior, Montana and then Missoula.  In 2004, I opened Health Solutions and focused on peri-menopausal problems, gut issues, and pelvic floor problems.  Soon after opening,  the demand for primary care services led me to offer the full spectrum of primary care to patients 12 and older.

I love playing in the outdoors, gardening, and my dogs.  My husband, Michael, and I have two grown girls between us.  Together, Michael and I work on following the same advice I give patients: eat healthy, be active, and deflect stress by practicing being "in the moment" and following your passions.

 


More on the Ideal Medical Practice Model:

THE MARK OF AN IMP

The key principles ideal medical practices pursue are high-quality, patient-centered, collaborative care; unfettered access and continuity; and extreme efficiency.


IDEAL MEDICAL PRACTICES TYPICAL PRACTICES

Care is driven by the patient's needs, goals and values.

Care is driven by the practice's priorities.

Access is 24–7.

Access is 9–5.

The practice uses technology to its fullest (e.g.,
electronic health records, e-mail, Internet scheduling).

The practice avoids new technology.

Patients can see their own provider whenever they choose.

Patients must see whoever is available or wait weeks for their provider.   

The majority of the office visit is spent with the provider.  

The majority of the office visit is spent waiting.

Overhead is low.

Overhead is high.

Providers are able to see fewer patients per day.

Providers must generate high numbers of visits per day to cover overhead.

Patients can be seen the same day they call the office.

Patients typically wait for an appointment.

Practices measure themselves regularly.

Practices have little or no performance data.

Practices are proactive in their care of patients with chronic illnesses.   

Practices are reactive in their care of patients with chronic illnesses.

Providers are satisfied and feel in control.

 Providers feel harried and unsatsified.