Support and Encourage

Our current healthcare system allows things like finance, technology access, and administration issues to influence patient health outcomes. The focus has been taken away from the patient and their concerns. This is unfortunate since the goal of all healthcare providers is the same: to provide the best health outcomes to all those who come to us for help.

The result is a system that deprives both patient and providers with what we feel are the three most important aspects of any patient/provider relationship:

  1. Access to healthcare
  2. Continuity of care
  3. Open, unfettered communication

This triad of principles helps providers progressively build upon the therapeutic relationship with patients. And when they are able to be practiced, patient health outcomes improve.

It wasn’t long ago when primary care physicians saw these three principles as a given to any patient relationship. But today, many primary care physicians feel tired, overworked and underappreciated, except by those that matter most–their patients. So can primary care physicians achieve the balance of a high-level of personal care and enjoy a high quality of life? In short, yes.

In 2007, I decided to leave a hospital employed primary care practice and give it one more try, wanting to improve the healthcare of patients and rediscover my passion for helping others; to practice in a manner that allowed me to do all those things Family Docs should be able to do. I also wanted to regain some work-life balance and professional autonomy. We started by focusing on what we felt the optimal interaction with the patient would look like, and built everything around this. The results have exceeded my expectations.  I have found small practice life to be fun and rewarding, providing a fertile ground for innovation and ideas that can be implemented quickly.

There are many questions like:

  • Is it complicated? (does not have to be)
  • What about billing? (software has improved vastly)
  • What about an EMR? (software has improved vastly)
  • What do you mean, giving all your patients your cell number? (I am rarely called, and happy when I am)
  • Do you miss that regular paycheck? (not in the least)
  • Do you still spend time in the evening doing charts? (never)

Each circumstance is unique.  The most efficient way to communicate is still email or the phone. Please be in touch.  We are happy to share our experience, advice, successes and stumbles.

In the meantime, ask yourself a simple question:  Is each interaction with a patient as ideal as it can be?

If not, we encourage you to do what we did and make a change. Follow your instincts. If a new system of patient interaction needs to be built, help your organization do it, or do it yourselves. After all, you are the Primary Care expert.


If there is one thing I would heartily endorse, it would be to spend some time with these folks. IMPs are a group of hundreds of physicians who question everything, and frequently find that the way things are done in large practice makes little sense to a physician or patient. This group has, literally, centuries of collective wisdom about the nuts and bolts of small practice life, from the very practical, to the highly philosophical. Monthly group “calls” and online access to other IMPs are invaluable. Nearly all are physicians who have grown weary of the treadmill and struck out on their own. In a small practice, there may be a tendency to feel you are “on your own.” This group has filled that void for me, providing a great group of innovative primary care thinkers with which to interact.

This site is another must for those looking to collect information that is actually clinically useful and actionable. In the past, our officewould ask patients to do patient satisfaction surveys. Our staff would groan, and we would receive the results months later, when they were of very limited use. We discussed using HowsYourHealth, but it went nowhere. As a small office, your patients can start using this with little fanfare, no expense, and no meetings! It has been an indispensable ‘tool’ for our practice.

The Rebirth of the Solo Family Doc
Once in a while, I am heartened to read a piece by a respected physician that echoes our feelings and supports our successes of swimming against the current tide of health care delivery. This time the recognition and encouragement come from Dr. Jeff Sussman, MD. Editor in Chief of the Journal of Family Practice. Thanks Jeff

Simply Contact Me: [email protected]
I am always glad to share our perspectives with all who are interested in wanting to make a real change happen. Just drop me an email!

Patient Portal

Please visit our portal to self-schedule an appointment or communicate with our practice online.
(Enrolled patients only)

Pay A Balance

Click the button below to pay a balance.

Online Health Survey

Please take 10 minutes to complete this online health survey.

Your Medical Home

21 Hampton Road, Building 2, Suite 201 Exeter, NH. 03833

Phone: 603.418.6310
Fax: 603.418.6311

Office Hours
Monday - Friday, 8:30am - 5:00pm

Jim, born and raised on Cape Cod, attended the University of Massachusetts School of Medicine after graduating Phi Beta Kappa from the University of Vermont.  He completed his Family Practice Residency in Baltimore, Maryland in 1990, serving as Chief Resident during his third year.  After enjoying private practice for 5 years, he was one of the first Physicians to form CORE Health Services, a large, multispecialty group, serving on their Board of Directors.   After 10 years as an employed Physician, he established YourMedicalHome as an independent, Primary Care Practice, with a vision of the Patient Centered Model of Care.  He maintains privileges at Exeter Hospital, and has served on Medical Staff Leadership of that institution.

Various experiences, including involvement with the Institute for Healthcare Improvement, the Ideal Medical Practices Collaborative, the Dartmouth Cooperative Research Network as well as practicing in a number of different Primary Care Models has provided Jim with a unique perspective into what works, and what does not work, in the Primary Care Setting.  He has found the smaller practice model to be an ideal way to bring innovation in care delivery quickly to where it matters most, the patient.  This can be as simple as a phone system that allows all (including Physicians) to answer the phone, to patient direct online scheduling, to the encouragement of email communication, or to something as ‘old fashioned’ as regularly performing house calls.

Jim believes that excellent and timely communication, easy access and continuity of care are absolutely critical to the care we provide, and believes that all we do should augment these goals.  He enjoys speaking about any issue involving the practice of medicine and greatly enjoys the long term relationships with the patients of the practice, realizing that these insights can be very important in the provision of the care they need, and want.

You may see him jogging, biking or rowing around the Seacoast.  He is married to Casey (see below) and lives in Exeter with Casey and their four children, two girls followed by two boys.

Kareen is an Osteopathic Physician. Growing up in a family of ten children in suburban Boston, she knew that she wanted to be a “Family Doc” since the age of eight. Her background training includes an undergraduate degree in Biology from Saint Michael’s College in Vermont, and a Doctor of Osteopathic Medicine from the University of New England in Maine.  For over 20 years, she has been committed to helping patients achieve better health. Kareen believes that being healthy is a partnership between the patient and the physician, and is committed to helping guide her patients to a healthier life.  Kareen is passionately interested in preventative care, fitness, exercise and other lifestyle choices the patient can make to deal with stresses that contribute to so many illnesses.  She is quick to prescribe lifestyle changes and exercise, and is slower to suggest “fix-it pharmaceuticals” which often only treat symptoms, not their underlying causes.  She has been involved with the developing science of Resiliency Training through the University of Pennsylvania, helping teach these techniques to those in the military.

Kareen lives on the Seacoast of New Hampshire with her husband of over twenty years, Peter.  They are avid cruising sailors, and have cruised from Newfoundland and Labrador, through the coast of Maine, the Caribbean, in Ireland and England, and the South Pacific.  Kareen is committed to physical fitness, particularly enjoys being with her large extended family, reading, photography, travel, amateur woodworking and loves old quilts. Kareen sees patients in the office a couple of days per week, and makes house calls when necessary.  When not in the office, you’ll often find her somewhere on the water!

Casey, a Pediatric Nurse Practitioner, was born and raised near Washington DC.  She received her Bachelors of Science in Nursing from Fitchburg State College, graduating Magna Cum Laude.  She earned her Masters in Nursing from the University of Maryland while working at Children's Hospital National Medical Center in Washington, DC. Casey has more than 20 years of experience caring for children in the outpatient setting.  This experience, coupled with raising four children of her own, gives Casey ample perspective and empathy, with regards to the unique needs of our pediatric patients and their families.

Casey is married to the ‘other’ Bloomer in the practice and enjoys her large extended family, being the 9th of 10 children.  You might also see her running around town, literally. She values spending ample time with all families to address whatever issues might arise.

Susan, a Family Nurse Practitioner, graduated with a Bachelor of Science in Nursing from UMASS, Lowell in 1979. She enjoyed working in a variety of settings including the Greater Lawrence VNA, and during the early 1980s was thrilled to be involved in the planning and development of the hospice program for that organization. While working and raising her children, Sue went back to UMASS to obtain her Masters Degree in Nursing. She has had the pleasure of working for 16 years in Family Practice with Michael Lannon, MD, until his retirement in August 2010 at which time she joined YourMedicalHome. She has learned so much over the past 30 years of nursing practice, both from her coworkers and particularly from her patients. Sue believes that listening is crucial to helping people and looks forward to meeting with patients and their families, listening to their concerns and working with them to develop a plan of care to optimize their health. Sue lives on the Seacoast with Tom, her husband. They have three grown children and an overgrown Westie. She enjoys being outdoors, walking, hiking, XC-skiing and spending time with her family.

Current Patient Contact Form

All of the fields below are required. Please do not leave any fields blank. Scroll down to view the entire form.

New Patient Contact Form

All of the fields below are required. Please do not leave any fields blank.