Private Medical Group Helps Babies

By Robin Williams Adams
The Ledger
http://www.theledger.com

The medical team at Lakeland OB-GYN feels a little left out with all the talk about the primary care medical clinic that Central Florida Health Care is establishing in Lakeland with help from Polk County’s indigent-care sales tax.

That clinic, due to open in four months, will offer general care 76 hours per week. With an income-based fee scale, it will see patients who lack insurance as well as some who have coverage.

It’s expected to increase access to health care and to reduce inappropriate emergency room visits.

Lakeland OB-GYN, a private medical group, has no problem with any of that. It’s just that, in the news coverage on getting a contract signed between Central Florida and Polk County, the upcoming clinic was referred to as the first that Central Florida Health Care would have in Lakeland.

Only recently has the word started getting out: Central Florida Health Care already has an inroad in Lakeland for gynecologic and obstetrics care.

Since January, Lakeland OB-GYN has dedicated part of its space as a satellite of Central Florida.

It’s a relatively uncommon public-private partnership that Dr. Peter Alvarez, president of the local group, said can be a model for other doctors and county officials to consider.

The care Lakeland OB-GYN’s six midwives give, from birthing babies to doing basic gynecologic treatments, now is under Central Florida. So is the care given by Lakeland OB-GYN’s five doctors when they treat women through that program.

Central Florida Health Care leases the services of the midwives, some services given by doctors, the facility and equipment such as sonograms. Women get care that can keep them from arriving at the ER in labor without having a doctor or midwife, he said.

Like the new clinic Central Florida will run, which will see a broader range of patients, the Central Florida-Lakeland OB-GYN partnership is one way to get care to people who need help.

And they have the babies to prove it, among them young Landon Moore, 6 weeks old, son of Megan Vargo and Kyle Moore. He accompanied his mother Friday as she came for a routine post-delivery checkup by one of the registered-nurse midwives.

Vargo, 22, sought out the clinic early in her pregnancy because she didn’t want to use a Health Department clinic .

“I never thought of getting a midwife when I came here, but I would do it all over again,” she said, praising the midwives.

“They put up with me. They’re women and they know what you’re going through.”

Vargo, on Medicaid, had more options than some women do.

“About 20 percent of the patients who come here have no insurance at all,” Alvarez said. “No Medicaid. No nothing.”

Lakeland OB-GYN, which added its first midwife in 1991, accepted Medicaid patients well before linking part of its practice with Central Florida. In recent years, Alvarez said, the impact of Medicaid and rising malpractice insurance costs was causing problems.

When he heard about Central Florida Health Care, a federally qualified center running established clinics in Frostproof and Dundee, he saw a possible solution. A federally qualified health center is required to accept all patients and bills those who lack insurance on a sliding, income-based scale. That’s their attraction for uninsured or underinsured patients.

For Lakeland OB-GYN, reduced legal liability is the advantage of seeing some patients through its Central Florida partnership. If a patient in the Central Florida part of the practice files a lawsuit, it’s heard in federal court. More importantly, Alvarez said, the suit is against the federal government, which assumes the financial responsibility.

Lakeland OB-GYN has been able to do away with malpractice insurance for its midwives. It carries some for its doctors, Alvarez said, but the cost is lower because some of their patients are seen through Central Florida.

It took more than a year to work out the details of the Central Florida-Lakeland OB-GYN relationship, as well as remodeling the practice to expand the space and to have separate entrances as required for the private and federally sponsored practices to co-exist, he said.

“It’s kind of a unique marriage,” Alvarez said, pointing out that Lakeland OB-GYN covered those costs itself.
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