Penrose bucking trend of putting doctors on payroll

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The business model for medicine is changing — and the way doctors practice will change with it.

Boutique medicine is on one end — and Wal-Mart walk-in clinics are on the other. Working directly for a hospital is somewhere in the middle.

“Being part of a large practice associated with a hospital allows you to keep up with patient demand,” said Dr. Steve Berkshire, health care administration professor at Central Michigan University. “You give up being your own boss, but you also don’t have the hassle of reimbursements, malpractice premiums or dealing with insurance companies.”

Doctors spend about 43 minutes a day working with health insurance plans, according to a study by the Medical Group Management Association.

“Total staff interaction time systemwide, converted to dollars, equaled $21 billion to $31 billion each year,” the study said.

That translates to about $68,000 for every doctor, every year.

The researchers found that primary care doctors spend more time on these interactions than medical or surgical specialists, and nursing staff members spend nearly four hours every day dealing with health plans.

“These data are yet another indicator of the dire need to streamline health care administration for physical practices,” said William F. Jessee, president and CEO of the Denver-based MGMA.

Jessee said reform could save doctors’ offices nearly $40 billion during the next 10 years —  and it could keep doctors practicing in their own private settings, instead of in hospitals.

Penrose-St. Francis Health Centers is bucking the trend of putting doctors on the payroll.

Unlike Memorial Health System, which is actively moving to create a model that will hire doctors, Penrose only has five physicians on staff: two cardiothoracic surgeons, one gynecology oncologist and two medical oncologists.

“We contract with a large physician group for our emergency services,” said Patrick Menzies, vice president of business development at the hospital system. “And we rely on physician partners as well.”

Doctors can choose to practice hospital-based medicine at Penrose — and the hospital will be reimbursed for the hospital portion of the bill, he said, which puts Penrose in competition with Memorial Health System for patients.

“We focus on being the most efficient,” Menzies said. “If we can be a little more efficient and a doctor can perform one more surgery, then it’s a financial benefit for him to come here.”

About half the doctors in the area practice at both hospitals.

Carol Walker, executive director of the El Paso County Medical Society, said the trend is apparent at the national level and in some places in Colorado — but has yet to catch on in El Paso or Teller counties.

“We don’t have a problem at this point, but there are signs that down the road, that will happen,” she said. “With health care reform, a lot of doctors are trying to be ready and make changes in response to what’s going to happen in Congress.”