Sparks CEO: Area Short 100 Physicians
By Ben Boulden
Between 100 and 150 more physicians could practice in the Fort Smith region, and Sparks Health System would like 30 of those, Ted Woodrell said recently.
â€œIf you look at our region, we are way undersupplied by physicians,â€? said Woodrell, Sparks chief executive officer. â€œI think personally that Fort Smith could use another 100 to 150 physicians today.â€?
He said Sparks would like to hire another 30 physicians in the next 18 months and will work with the medical community for even more. About 90 physicians work at Sparks Medical Foundation, the physician practice thatâ€™s part of the health system, said Greg Russell, Sparks spokesman.
Doug Babb, Cooper Clinicâ€™s chief executive officer, stated in an e-mail that its â€œtop priorityâ€? is recruitment but didnâ€™t estimate the number Cooper or the region needs.
Cooper Clinic physicians, many of whom see patients at St. Edward Mercy Medical Center, number about 100, according to information on the clinicâ€™s Web site.
When assessing patient demand and physician supply, the Sisters of Mercy Health System, based in St. Louis and operating St. Edward Mercy Medical Center in Fort Smith, looks at a 14-county area, said Kelly Ford, the systemâ€™s director of physician recruitment.
â€œ(One hundred) may be a bit on the high side,â€? she said. â€œCertainly, our service area spills into Oklahoma, Scott County and some of the other areas that would be underserved from a primary care standpoint. When we look at the big picture, itâ€™s probably not that far off the mark.â€?
The shortage is nationwide, Woodrell said, and in Fort Smith includes a need for both primary care and specialty doctors.
Data on physician employment for the Fort Smith Metropolitan Statistical Area wasnâ€™t available, but according to the federal Health Resources and Services Administration, Arkansas ranked 48th among states in physicians per capita.
It also ranked 29th among 46 states with medical schools and in medical school graduates per capita.
Woodrell said not training and educating enough physicians in Arkansas is the most important cause of the shortage.
Not having enough physicians at Sparks Health System, though, also has meant a monthly financial loss of about $500,000, he said.
Although operations of Sparks Regional Medical Center are in the black, Sparks Medical Foundation, the systemâ€™s physician practice, continues to bleed red ink.
â€œWe need to continue to drive volume to our enterprise,â€? Woodrell said. â€œWhen we do that, things will get dramatically better. When you have a large health care enterprise like this, your fixed costs are very high. As you build volume, that incremental cost of bringing on another patient is very low. The fixed cost is already covered. You have to keep feeding the system.â€?
To stop and reverse its recent financial losses, he said Sparks Health System needs to grow services and staff, not cut. The area has a supply problem of physicians, nurses and pharmacists but has no difficulty finding patients to serve.
When a physician is looking to set up practice in a city, Dr. Jerry Stewart said, the state of medical facilities and technology in that place are a factor.
â€œIt is important,â€? he said. â€œIt isnâ€™t the only thing they look at. It is one of the things they look at.â€?
Stewart is a retired chief executive officer of Cooper Clinic and a retired pulmonologist.
Woodrell said the quality of life in a city, the quality of education for the children in a physicianâ€™s family and how well referrals work are all factors, too, but one side benefit of the Renaissance Project at Sparks is making an â€œimportant statementâ€? about the institutionâ€™s commitment to quality facilities and health care.
The centerpiece of the Renaissance Project is the construction of a new 142,000 square foot, $40.4 million emergency and critical care center slated to open by January.
Once completed, the center will allow for departments like imaging and emergency to interact more efficiently and operate more efficiently on their own as well, Woodrell said.
That can positively affect the morale of physicians already present and help drawn in new doctors.
Stewart said he saw Cooper physicians who care for patients at St. Edward had an â€œextremely positive reactionâ€? to having the more up-to-date, easy-to-use medical facilities at that hospital.
In June 2002, St. Edward completed a 320,000-square-foot expansion creating its Centers of Excellence.
What benefits can be reaped from a new building also can be garnered from new technology.
On July 23, Sparks turned on its OneChart electronic medical record system. All records related to the use of pharmacy, laboratory services, imaging and other records for a patientâ€™s care are now unified in a single electronic medical record.
Electronic medical record initiatives are rolling out at St. Edward and large hospitals around the nation, and now, Sparks is catching up.
It spent $4.17 million on the first phase of implementation of the $17.7 million, 39-month project.
Greg Russell, Sparks spokesman, said the second phase will begin Oct. 1.
New OneChart billing and scheduling functions will be installed on the system at Sparks Medical Foundation.
Implementation of the second phase will take place over 2008, Russell said, and the third and final phase will be realized in 2009.
Once the new OneChart patient accounting system is put in place in 2009, then Sparks will be able to use a â€œtrue shared electronic medical recordâ€? for all billing and clinical functions for all its patients, he said.
That will give new physicians something they enjoyed in medical school and expect to have wherever they practice.
â€œYou have to have quality facilities and equipment if youâ€™re going to attract young physicians or keep existing physicians,â€? Woodrell said. â€œLetâ€™s face it, thereâ€™s a big difference in practicing where you have all the technological advantages and where you donâ€™t. Young physicians are used to that and dependent on that. If youâ€™re wanting to attract young physicians, then you better have the tools they are used to dealing with. The competitors have it.â€?
While OneChart and the Renaissance Project promise to improve efficiency and make it easier to recruit doctors, he said it also will give Sparks the tools it needs to improve the quality of patient care â€” the end goal of all these efforts.
â€œI am a big believer that if you canâ€™t measure it, then you canâ€™t manage it,â€? he said. â€œWeâ€™re trying to select the key indicators of quality and measure it. We can do it really quickly with OneChart. Weâ€™ll keep pushing that data out to make good, intelligent decisions. Weâ€™re really devoting ourselves to quality care.â€?
The quality of cardiology care at Sparks is something the hospital received criticism for recently.
Hearts And Brains
Sparks Regional Medical Center was one of seven hospitals in the United States with a 30-day death rate from heart attack. The rate was worse than the national rate.
The Centers for Medicare and Medicaid Services and the Hospital Quality Alliance collected the data for patients with Medicare discharged from about 4,500 hospitals from July 2005 to June 2006.
Since June 2006, Sparks has hired Dr. Barry Uretsky to direct its cardiology program.
â€œWeâ€™ve instituted all the American Heart Association guidelines,â€? Woodrell said. â€œI think our outcomes, our data are going to be excellent as theyâ€™re monitored into the future. Weâ€™re continuing to grow our cardiology program and solicit additional cardiologists to join us. As we do that, I think our outcomes will be comparable to anyone in the country. Weâ€™re making great strides.â€?
If it is necessary to transfer patients to hospitals elsewhere in Arkansas or Oklahoma to get them care because there is no physician specialist available locally, Woodrell said Sparks will do that.
â€œWe work hard to make sure we have proper referral,â€? he said. â€œOf course, our first goal is to take care of them here if we can.â€?
He said he thinks Sparks and St. Edward can â€œwork collegiallyâ€? to attract physicians to the area rather than compete.
Itâ€™s what the area needs and what Sparks needs to undergo an economic renaissance, said Woodrell.
â€œThereâ€™s so much need out there, huge clinical demand,â€? Woodrell said. â€œWe donâ€™t have to steal patients from St. Edward to survive. What we have to do is get physicians to come to our community for health care. Itâ€™s also great business for our community and spins off a lot of income. Health care needs to be a big magnet and continue to grow.â€?