What a pity hospital administrators skipped "Phy-Cap '96," one of the biggest card-trading, dealmaking meetings on physicians' busy business calendars this season.
With skimpy turnout by hospital types at the confab in Charlotte, N.C., nary a kind word was heard about hospital-physician partnerships.
The National Association of Integrated Health Organizations-sponsored meeting brought together 250 high-level executives, a 25% increase from its first capital conference this spring. Hospital executives had been marketed hard to come, but few showed.
The meeting matched doctors who are hungry for information about forming larger groups and tapping capital markets with an eager bevy of financiers, consultants and physician practice management executives.
Judging by comments made at the meeting, the hospital executives' absence wasn't surprising. Brooks G. O'Neil, a Piper Jaffray senior analyst who tracks physician practice management companies, exaggerated to make the point: "We see zero physician-hospital relationships that are working today and think there will be even less in the future."
Looking to the hospital for capital is "a significant strategic error" because that capital "comes with strings," added Robert Margolis, M.D., chief executive officer of HealthCare Partners, a Los Angeles-based management services organization.
The problem is that hospitals want to move into the outpatient arena, but they don't realize that somebody else-the physician-already lives there, added Richard T. Vernick, M.D., former president of Allied Community Health System and now a consultant with the Hunter Group in St. Petersburg, Fla.
Richard L. Reece, M.D., chairman of the Fredericksburg, Va.-based NAIHO, which represents PHOs, IPAs, group practices and related members of the industry, said the meeting clearly met a need among physicians seeking basic information about group formation and capitalization.
"I think doctors are restless, and this is a credible alternative for them," he said. "They figure the hospital's in the back room manipulating them."
Big surprise.The sugary rhetoric we had been hearing from Capitol Hill on Medicare since the elections has already been replaced by the first partisan shot.
House Ways and Means health subcommittee Chairman William Thomas (R-Calif.) blasted President Clinton for "pure, cold, partisan, political demagoguery" on Medicare, which Thomas said will make it much harder for Congress to address reform this year.
Thomas added that Republicans would not release their own Medicare reform plan but would instead await the president's "detailed" proposal. Thomas said Republicans will scrutinize the plan to ensure it doesn't include any of the proposals that Clinton criticized on the campaign trail.
Before Thomas' outburst, Republicans, led by House Speaker Newt Gingrich, had been talking about working with the White House on Medicare.
The GOP's mostly conciliatory tone seemed to have mollified one of the Republicans' chief foils, Fortney "Pete" Stark (D-Calif.), the ranking minority member on the Ways and Means health subcommittee. Stark, who has had some entertaining partisan squabbles with Thomas, put out a very un-Stark-like (meaning nonpartisan) statement several days after the election.
"I believe we can easily compromise" on Medicare, Stark said, adding that if "Republicans are willing to limit their restructuring to proven methods . . . Democrats will support major Medicare cuts."
Sound health.The impact of the physical environment on medical outcomes has never been made clearer than through a recent study done for the Center for Health Design by researchers at Johns Hopkins University.
The report, presented at the Ninth Symposium on Healthcare Design in Boston on Nov. 15, provided two examples of how the design of a healthcare facility can be altered to promote better patient outcomes.
According to Johns Hopkins researchers Haya Rubin, M.D., and Amanda J. Owens, the studies focused on how noise affects patients.
In the first example, 38 emergency-room patients being treated for lacerations listened to music through headphones. Patients were able to choose the music and control the volume. Heart rate, blood pressure and respiration were monitored before, during and after the procedure. Of those who heard the music, 89% thought it was very beneficial and 100% said if they had future procedures they would ask for music again. In addition, the music listeners said they felt less pain and had lower anxiety.
In the second case, 70 healthy women were placed in a sleep lab with either quiet conditions or a recording of critical-care-unit sounds. The women exposed to the noise had less rapid-eye-movement, or REM, activity, the dreamy sleep that's critical to physical well-being. Because the study included healthy volunteers, it's not certain whether the results would translate to CCU patients. However, it's safe to assume that less REM sleep can be a problem for critically ill patients, the researchers said.
The researchers suggested a range of design options to facilitate noise reduction in CCUs and music in operating rooms.
A full copy of the report is available for $19 from the Martinez, Calif.-based Center for Health Design by calling 510-370-0345.
Strange bedfellows.A loan analyst working on a controversial proposal to privatize the $600 million Maricopa County (Ariz.) Health System is on probation for her role in the collapse of Phoenix-based Lincoln Savings & Loan Association, the symbol of the nation's S&L crisis.
Judy Wischer, once a key deputy to Lincoln principal Charles H. Keating Jr., is serving as a consultant to Stirling Capital Corp. The firm has asked her to review loan applications made by Healthcare Providers, a company that is seeking to take over management of the Maricopa system.
To settle civil claims against her and meet the terms of her probation for her conviction on fraud charges in the Lincoln collapse, Wischer agreed never to work again in banking.
Stirling, however, is not regulated as a bank because it doesn't take deposits from the public. Patsy Bingham, deputy U.S. probation director, said Wischer's work appears to meet conditions of her release.