Less paperwork, more care

In decades past, doctors fresh out of medical training jumped at the opportunity to practice on their own. They’d find a community, hang up a shingle and welcome new patients.

Over time, increased regulation, documentation and billing paperwork has made running an office a burdensome undertaking. Yet, medical schools devote little time to finances and management. As a result, few new doctors care to go into private practice, while many longtime doctors seek to avoid grappling with the logistical aspects of business ownership.

Paradise, like many communities, is feeling the pressure. The Ridge can be a challenging place to open an office, and it takes considerable effort to attract new physicians.

Feather River Hospital has found a solution by creating a series of hospital-based outpatient clinics (HBOCs) in which physicians still practice independently, but their medical offices are drawn under the hospital’s umbrella. Through the HBOC system, the hospital procures office space, equipment and supplies; handles billing and insurance hassles; and employs the staff.

“Our goal is to provide a venue where services are provided and the doctors have the support network they need to provide those services to people on the Ridge,” hospital CEO Kevin Erich said. “We provide the infrastructure, and that allows the physician to concentrate primarily on medicine and not be so concerned about the operational side.”

Currently, Feather River runs eight such clinics, incorporating eight doctors as well as other mid-level providers such as physician’s assistants, nurse practitioners and midwives. Two of the clinics—Skyway Primary Care & Wellness Center (on Raley Boulevard) and Feather River Midwifery Services (on The Esplanade)—are in Chico.

Having the HBOC framework has helped Feather River bring in new practitioners and also kept a couple from retiring. Erich said several doctors have recently approached Feather River about joining the HBOC network.

“This is not a big money-maker for the hospital; in fact, we’re probably lucky if we break even on the deal,” Erich said. “What’s more important about this is [the] alignment with the physicians, and continuing to serve the community the best way we can.”

Patients should notice little difference—apart from a new sign out front and the Feather River Hospital logo on their bills—because the hospital aims to keep established practices in their current locations and staffed by their current receptionists and nurses.

“We want the patients to feel comfortable,” said Maureen Wisener, assistant vice president for foundation and communications at Feather River. “We work with the physician and try to hire his or her existing staff, because the patients are used to seeing Sally at the front desk. There may be some new regulatory issues in effect [at the office] because the hospital owns it, but as far as the patient experience and the patient care, hopefully [the transition] is as seamless as possible.”

Feather River embarked on the HBOC process about four years ago, before Erich succeeded Wayne Ferch as CEO.

“We had a doctor come to us and say, ‘Hey, I just cannot continue to spend all my time administering my practice. I want to do something different. Can you help me?’” Wisener recalled. “This HBOC model was the best way to help that physician, and it also works for our midwifery clinics, and it’s also been intriguing to other physicians.”

That first physician, Dr. Ronald Ainsworth, continues to practice at his longtime office on Buschmann Road in Paradise, now called Feather River OB/GYN Associates. Feather River has since brought in two additional obstetrician/gynecologists for the Total Women’s Health clinic on Clark Road, as well as two OB/GYNs with wider scopes of practice for the Skyway Primary Care & Wellness Center.

Dr. Randal Sloop and Dr. Christine Sloop both practiced as OB/GYNs in Cincinnati, Ohio, before embarking on new training—Randal as a family medicine doctor, Christine as a registered dietician. Feather River established a clinic for them, where they were joined by physician’s assistant Bernadette Connolly and nurse practitioner Sally Vertolli. They opened their doors for business in October of last year.

“There are actually a considerable number of patients from Chico who come up here [to Paradise] and get services here,” Erich said, “and by putting something right at the base of the hill, we felt that would make easier access.

“Also, the Sloops’ clinic is a lot more about wellness; we want to continue down the road of how we can actually make our community healthier,” he said. “Going forward, that’s an initiative under the [federal] health-care reform as well, and we need to make sure we’re looking not only at how we’re treating patients—putting Band-Aids on patients—but [also] how do we keep them out of the hospital, how do we keep them healthy?”

Meanwhile, Feather River is negotiating with additional local doctors about converting their practices to HBOCs.

“Ultimately, I think this will be to their advantage, to our advantage and to the community’s, because ultimately it will allow us to work through some of the challenges we have moving forward,” Erich said. “Our goal long-term is to make sure we’re still here providing care for our community.”