Hospital Care Group

“We have the expertise to take care of these kinds of patients,” said Dr. Khurrum Shaikh, a hospitalist.

Shaikh and Mark Drapala founded the Hospital Care Group in October 2012. Since then, they’ve signed on five clients in northeast Indiana and northwest Ohio.

They hire physicians, who are assigned to work in client hospitals in much the same way an accountant or other professional might work as a contractor assigned to an office. Hospitalists coordinate care and services for patients admitted to a hospital.

Shaikh (pronounced “shake”) first teamed with Drapala in 2007, when they worked for Parkview Health.

Similar programs cost hundreds of thousands of dollars to implement, a cost many smaller hospitals can’t afford, Drapala said. The Hospital Care Group’s fees are based on a hospital’s patient volume and can be anywhere from 30 percent to 50 percent of the cost of a full program, he said.

National median salaries for hospitalists are higher than those for primary care doctors, according to sources. The Society of Hospital Medicine, a professional group for hospitalists, said a 2012 report showed median compensation of $233,855 for internal medicine hospitalists. That same year, the Bureau of Labor Statistics reported general internists received $191,520 in mean wages. Neither organization reported numbers for both physician specialties.

The Hospital Care Group, which employs four doctors and two nurse practitioners, specializes in working with hospitals with fewer than 200 beds.

Connie McCahill, Cameron Memorial Community Hospital’s chief operating officer, said the Angola hospital has contracted with Hospital Care Group for one year.

She’s never received a complaint that a patient preferred his primary care doctor to the hospitalist.

“The physicians maintain a high level of communication,” McCahill said, adding that many primary care doctors visit patients at the hospital. “From the patients’ perspective, it’s a team effort.”

Many patients who come into the emergency room don’t have primary care doctors, she said. Having a hospitalist allows them to receive high-quality care, regardless.

Dr. Shaikh, one of two hospitalists assigned to Cameron, said patients’ families appreciate not having to travel to visit hospitalized loved ones. Smaller hospitals often transfer seriously ill patients to larger, regional hospitals, he said.

A trained hospitalist allows smaller hospitals to provide necessary care, which increases hospital revenue, he said.

Cameron has transferred fewer patients since hiring the hospitalist service, McCahill said. But she doesn’t have exact numbers. Overall, the hospital has also seen an increase in the number of patients and how sick patients are.

Providing high-quality care to all patients is the driving force behind the contract, McCahill said. She was unwilling to estimate how much the nonprofit hospital is paying Hospital Care Group versus how much additional revenue it takes in because patients stay longer.

“There are so many soft costs and soft benefits that you can’t quantify in a dollar amount,” she said.

But, McCahill added, Cameron wouldn’t have the program if officials didn’t believe it offers value to patients and the community.

Mercy Western Region in Defiance, Ohio, has contracted with Hospital Care Group for a little more than a year to cover evenings and weekends when the one full-time hospitalist is off duty. That doctor works weekdays from 7 am to 7 pm.

The hospital still transfers patients to larger, regional hospitals at the same rate as before. But it’s now easier for local doctors because they can limit their practices to office hours, said Chad Peter, president, and CEO. Mercy Western Region includes a hospital and a clinic.

More and more doctors in the Defiance area prefer to see patients exclusively in their offices, he said.

Peter believes patients benefit from hospitalist care because the program ensures a doctor is either in the building or on call at all times. The result is a faster response when nurses have questions or concerns, he said.

The approach has proved beneficial at larger hospitals, local officials said.

Lutheran Health Network started using hospitalists in September 2006 at Dupont Hospital. Since then, the program has grown to include about 25 hospitalists working at five Lutheran-run hospitals, officials said.

“The main objective is to help the hospital deliver care as efficiently and effectively as possible regardless of the hour,” Brian Bauer, Lutheran Health Network’s interim CEO, said in a statement. “We’ve found the growth of our hospitalist programs to enhance the continuum of care and patient experience.”

Parkview Health employs 28 hospitalists who work at Parkview Regional Medical Center and Parkview Hospital on Randallia.

Hospitalists don’t cover Parkview’s community hospitals in Huntington, LaGrange, Noble, and Whitley counties. Primary care doctors continue caring for their patients in those hospitals, spokesman Eric Clabaugh said.

Spencer Grover, vice president of the Indiana Hospital Association, said hospitals of various sizes have increasingly embraced the contractor model as a way to stock their staffs with specialists.

Grover, based in Indianapolis, previously worked for a company that managed hospitals by contracting out CEOs.

This allowed health care executives greater upward mobility, making it easier to transfer from a smaller to a larger hospital, he said.

Smaller hospitals can hire experienced professionals who might not otherwise be willing to risk coming to a smaller, rural market. Also, it relieves them of the hassle of the interview process, Grover said.

But the trend doesn’t end at CEOs or hospitalists. Some hospitals contract with companies to provide emergency, radiology, or neurology care.

“There’s plenty of contracting going around,” Grover said.

Many recent medical school graduates believe they can be just as productive and efficient while restricting their practices to office hours when they treat patients with chronic conditions, including diabetes, high blood pressure, and high cholesterol.

Those family practice doctors don’t see congestive heart failure, pneumonia, and other serious illnesses as often as hospitalists do.

Also, primary care doctors increasingly consider traveling between the office and hospital – or hospitals in the case of Fort Wayne and other larger cities – as a time-waster.

Modern medical practices don’t resemble those found on T.V. dramas from the 1970s, Grover said.

“It’s a lifestyle issue,” he said. “There’s no Dr. (Marcus) Welby anymore with a 24/7 schedule.”