New medicine

With a futuristic view toward record keeping and a retro approach to customer service, Dr. Roy Bishop is sure his Argyll Medical Group can succeed where other doctors’ groups in Butte County have failed.

The four primary-care physicians are setting up shop in Chico and will be open to patients on Aug. 15.

Bishop, with his Tartan tie and Scottish accent, makes an immediate impression as he displays his knowledge of medicine, technology and business.

At only 36, he brings an education from Oxford and Glasgow universities (he was in the army in Scotland) and, in the United States, experience at George Washington University Medical Center in Washington, D.C.

Bishop’s approach is to not go where he figures now-vaporized-from-Butte-County medical groups such as Sutter Health, UC Davis and Adventist Health went wrong. “They came from outside Chico. They didn’t understand the local market,” said Bishop, who was recruited by Sutter Health to come to Chico in 1997. The out-of-towners had good doctors, he said, but their overhead was too high—58.5 percent compared to Argyll’s 38.5 percent—and the groups lacked strategy and direction.

Bishop believes that Argyll will help fill a void left by the departure of those groups, as Chico needs more doctors to serve a growing population.

When Argyll Medical Group opens at 100 Independence Circle in Philadelphia Square, it will usher in a new era for health care in Chico—in large part due to its mind-boggling array of technology.

Patients will be able to log onto the Internet and see their records and lab results—even book appointments and e-mail questions to their doctor and participate in online discussion groups. There will be Internet terminals in the waiting area. There won’t be charts in the folder-and-papers sense. Paper that comes into the office will be scanned into the computers and then shredded. The doctors will have notebook computers so “we can do anything at home we can at the office.”

“They’re young, computer literate and personable—committed to customer service as well as good medicine,” Bishop said of the doctors he’s brought on board: Forrest Olson, Jeanette Sibal and Louise Krone.

Some insurers—Blue Shield is a standout, Bishop said—are supportive of and will pay for such services as Web-based doctors’ visits. A two-way Web camera consultation counts as a “real” consultation, so that’s covered.

At any rate, Bishop said, Argyll will always be up-front with patients about the services they’ll be billed for. And it will take every type of insurance that’s accepted around here, except, regretfully, the difficult-to-deal-with MediCal, unless it’s paired with Medicare benefits. Patients can also “self-pay” at $32 per office visit. Bishop expects most of the patients will have “PPO” policies, where they pay extra to pick their own doctors.

All that tech stuff won’t make the office feel like a jumble of wires and machines; it’s just “so that we can give them better service,” Bishop promised. “The main focus is on providing high-quality, personal care in the office.” A real person will always answer the phones, and anyone on staff can access a patient’s medical records and relay information. And, because of the lower overhead, he said, “We can afford to spend more time with patients.”

Furthermore, said Bishop, proudly explaining the Scotland-inspired decor that will be complete with a water wall, “It’s a nice, calm, relaxing place.”

All this may sound kind of out-there for little old Chico, but Bishop said, “I reckon within five to 10 years this will be normal.” Catering to customers and lowering overhead, he says, is the only way to compensate for “falling reimbursement and rising costs.”

“We’d like to spend more time helping patients rather than trying to outwit the insurance companies,” he said. “Most physicians are not talking about greed. They’re talking about survival.”

The doctors will be employees for the first two years and then become self-employed as franchisees. Courtney Hille, who has experience working for several Chico businesses, will manage the group.

Each doctor’s patient load will be about 3,000, and if more business comes, they’ll add another doctor and more office space rather than compromise service, Bishop said. “We never want to close to new patients. We will go on adding doctors.”

Elizabeth Mitchell, spokesperson for Enloe Medical Systems, said all of Argyll’s doctors are expected to apply for privileges to be part of the hospital’s medical staff. Enloe can’t play favorites, of course, but Mitchell said that as part of its strategic planning process starting in 1995, “a need for additional primary-care physicians was identified.”

If new doctors set up shop in Chico, she said, “that’s all a good thing.”

Dr. Jimmy Roberts, who is president of the Butte-Glenn Medical Society, said that while he’s not familiar with the specifics of Bishop’s plans, Chico certainly needs more doctors.

“In California, we’re having a difficult time recruiting and retaining physicians,” he said, mostly due to the managed-care system and its low reimbursement rates. “There’s a demand for both primary-care physicians in this community, and there’s a demand for specialty physicians.”

In Chico, Roberts said, there’s been a “graying” of the physician community. Many are taking early retirement rather than deal with HMO hassles, and most doctors here are 45 or older. He added that most of the doctors who had been with groups like Sutter stayed in town after the groups pulled out. But he said, “most of those practices are mature practices” and aren’t taking on new patients.

Bishop is more than confident that his risk will pay off. He’s secured loans from Tri Counties Bank and U.S. Bank Corp., and all told the investment in Argyll is half a million dollars. His business plan calls for a profit in the second year.

But besides turning a profit in the changing world of health care, Bishop said, "We want to be the nicest primary-care doctors in town."