The times, they are a-changing. My practice is in the process of becoming a different type of practice, with prevention and personal care at its center. That's what I've always tried to do, but I have found a new practice model in which I can really focus on wellness and preventing the complications of illnesses.

MDVIP, a subsidiary of Procter and Gamble, allows physicians to work with a smaller number of patients, as a combination old-style family doc, health coach, and technical medical expert. I will be able to spend the time with each patient, and his or her individual problems, that is necessary to achieve the best results, both for healthy living and for the treatment of illnesses when they occur.

My practice size will decrease to less than 600 patients, from its current 3500-4000. Each patient will have a yearly physical examination that is extremely comprehensive. These are sometimes referred to as "executive physicals," but a better term would be a comprehensive assessment and annual health plan. We will work together to form goals and benchmarks for the coming year, and I will help each person to reach those goals as time passes.

In addition, since the practice is much smaller, visits will be on-time and as long as is needed. Each patient will have my cell number to reach me on evenings and weekends, with instructions to actually use the number when they need to talk to me. I won't be trading call on weekends anymore, so I will be the one to return the calls. Patients can expect to get in for problem visits the day they call, or the next day. One of my goals is for my patients to have no idea what an urgent care center looks like.

There are many other layers to this type of practice. I am very excited about starting. You can learn more about the practice at www.StevenBurnsMD.com.

The change in practice occurs on December 28, 2010. Call if you want to know more about the MDVIP practice.

Foggy Canyon

From the precipice a fog blanket,
thick and opaque and still and gray,
eclipses the chasm below.

The trail, steep and narrow
limestone path of muley mud,
dives out of sight into the mist,
beckoning.
I follow its blind lead,
blinking in wet air below.
Gray leads into gray,
five, six, eight feet ahead,
canyon grandeur captured in a
small mist box.

Ahead, low mountain sage grows,
its trumpet flower hanging gold in still air.
Hummingbirds hum below the mist
as the sun breaks the canopy wide,
penetrating the canyon.
Morning wakes,
delayed as a lover who stays
for one more caress as he leaves the bed
rejuvenated, vitae interruptus,
resuming life again.

Looking under the cloud, I--
open-mouthed with wonder--
see cliffs and plateaus,
temples and spires,
Kaibab limestone above,
Vishnu schist below,
Rio Colorado below,
sun-broken cloud above,
see them again
as if for the first time.

--by Steven Burns

A New Year, a new half-marathon

It's a nice, rainy morning, and I love it. I'm glad it wasn't raining yesterday. You see, I ran in the P. F. Chang Rock 'n' Roll half-marathon, and rain would have put a huge hitch in my getalong.

I met with 22,000 of my closest friends at ASU, and we took shuttle buses to the state capitol, 15th Avenue and Jefferson in Phoenix. There, a very large number of people milled around and waited in long lines for Port-a-Johns. A pretty good band was playing near the booths that were handing out bagels, bananas, water, and coffee. Then it was time to get ready to run.

I was in the 13th 'corral,' as we were grouped by the times we planned on finishing. My group consisted of maybe 400-500 people, and I suspect the groups farther back were much larger. At 8:30, we started moving forward, and as we reached the starting line, I saw Senator John McCain waving to the crowd from a platform 20 feet above the crowd. His face must have been hurting by then from all the smiling.

Immediately after crossing the starting line, the group spreads out, all the while jockeying for position. You're not really trying to pass other people--just trying to keep to your own pace, and not step on anyone else. It's sort of like driving on the freeway, but without all the anger and fear.

At 7th Avenue, we turned north and then at McDowell we turned east. I think that whatever 'runner's high' I had occurred before the 3 mile mark, which is 12th Street. By the 6 mile mark, I was in the groove, but my legs were beginning to complain that I was using them badly. Unlike last year, the 7 mile marker was not a discouragement. Last year, I realized that I was only half way there, and that was disappointing. This time, my thought was, "I'm half way there and I'm not dead yet."

At 12 miles, a song came on my iPod that was most timely. "Everlasting God," by Lincoln Brewster, came on with "Strength will rise as we wait upon the Lord," and "You lift us up on wings like eagles," and finishing with a child reading Isaiah 40:28-31, which concludes with "...those who wait on the Lord will find new strength. The will fly high on wings like eagles. They will run and not grow weary. They will walk and not faint."

Now THAT's a runner's high.

Crossing the finish line is always a high, and this time, I didn't feel like I had to walk across the line. I stopped as soon as I could, and texted everyone in my family that I was all done. In every way. This year, the organizers had Mylar blankets for the runners, and I was surprised how good it felt to be that warm.

Last night, Denise and Michael and I went to see "The Book of Eli," with Denzel Washington. It's an interesting movie, with some theological overtones. Mostly what Hollywood thinks that Christians believe. Anyhow, I stood up after being seated for quite a while, and I was not sure my legs would hold me up. It's an odd feeling, and I was glad for the handrail in the aisle of the CineCapri.

Today, the thighs are pretty sore. I guess I'll start running again in a week or so, but for now, I'll just bask in the joy of having finished the race, again.