Selling lets docs focus on patients

Suzanne Hoholik
THE COLUMBUS DISPATCH
http://www.columbusdispatch.com

Both doctors and hospitals can benefit when a hospital takes over a physician’s practice.

The doctors are freed from negotiating insurance contracts and paying for malpractice insurance; they can stop being small-business owners and focus on medicine.

The hospitals gain doctors to cover on-call shifts, specialists when they need them and a stream of customers.

As a patient, you might not notice a change — you see the same doctor, pay the same co-pay.

But when your doctor knows you were in the emergency room before you say anything and has already looked at test results with a few taps of a keyboard, then you might sense that something is different.

Dr. David Kageorge worked in private practice for 20 years before realizing that running an office wasn’t what he wanted. He had become frustrated dealing with mounds of paperwork, meetings, malpractice insurance, employee salaries. He wanted to focus on patients.

Kageorge and Dr. Stephen Koch sold Pickerington Family Practice to Mount Carmel Health System seven years ago. They now work for Health-Providers, Mount Carmel’s for-profit physician arm, and are paid a percentage of the income they generate.

It is becoming more common for doctors who are aggravated about the business side of their practices to sell to hospitals.

“We are seeing and hearing a lot more about this,” said Tim Maglione, spokesman for the Ohio State Medical Association.

Mount Carmel handles the bills, fee collections and insurance contracts. The system pays for malpractice insurance and puts patient records on the hospital’s computer system.

That system allows Kageorge to keep track of which patients are due for a colonoscopy or mammogram and to quickly find out about drug interactions.

Most of Mount Carmel’s primary-care practices are located near Mount Carmel West hospital, so people who live in the area have access to doctors, said Cindy Sheets, senior vice president and chief information officer for the system.

At the same time, the hospital is seeing a steady stream of patients through its inpatient and outpatient services.

Physicians can refer patients to any hospital they want, but experts say these types of relationships create loyalty.

While Mount Carmel’s focus has been to add primary-care doctors, the national trend is to employ specialists that match a hospital’s service line — heart, orthopedics, trauma.

That’s the case for Children’s Hospital and OhioHealth, both of which employ more specialists than primary-care doctors, in part so they have enough physicians to cover all shifts.

“We run a trauma center and it’s almost impossible to find physicians who volunteer to work in a trauma center today,” said Bob Millen, chief operating officer for OhioHealth.

Deals with doctors vary. Some doctors are paid salaries, others are paid a percentage of the income they generate, and still others are paid based on performance measures.

Even though his business headaches are gone, Kageorge’s days aren’t any shorter.

And he still has meetings, but now he talks about patient care instead of insurance issues.
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