For Docs, Teamwork pays off

Leyton Braud has enticed primary-care physicians, a notoriously independent lot, to leave their practices and enthusiastically join Piedmont Medical Care Corp. under one primary condition: “They do it our way.”

Braud’s not boasting. “Our way” only refers to the relatively mundane work that most practicing physicians don’t enjoy dealing with, anyway—like the business side of their practices. On the clinical side, except for quality measures, PMCC leaves its doctors alone.

“Other than quality standards, how they decide to practice is up to the individual physician,” says Braud, PMCC’s Central Business Office director. “If he wants to see 15 patients a day and accept that income, that’s what he does.”

PMCC is part of a larger strategy by its parent, Piedmont Healthcare, owner of Atlanta’s Piedmont Hospital, to not only employ its physicians, but to ensure that productivity doesn’t suffer as a result of those physicians being on salary—a major potential drawback to the employed physician strategy.

“These guys aren’t just drawing a salary,” Braud says. “They have to earn just like they would on a private practice. We just take care of the business side of it.”

To simplify things dramatically, PMCC physician salaries are based not just on how many patients doctors see, but on how productive they are in seeing patients—including working to ensure that patients don’t return for follow-ups for problems that should have been addressed initially, as well as seeing patients on time for appointments.

PMCC’s practice management system, from Horsham, Pa.-based NextGen Healthcare Information Systems Inc., went live in 2001. Doing billing for 105 physicians, most of whom are employed, isn’t easy, but Braud says the system helped cut accounts receivable days from 89 to 31 in 2003—a statistic that’s hovered around that level since. Based on this success, word is getting out, and many physicians are approaching PMCC to join the practice. In fact, Braud is working on ways to expand the model to work with specialists in the area, a few of whom already use PMCC for their business functions, though they are not employed.

—Philip Betbeze