Joining Forces Without Loss of Independence

David Bernstein, MD

Keeping a medical practice strong and independent in today’s turbulent environment can be quite challenging. More and more independent practices are struggling to remain viable, and some have chosen to either close or sell their practice to hospital systems or other institutions. At Woodlands Medical Specialists in Pensacola, Florida, we found another viable path to remain independent. We formed a collaborative relationship with The US Oncology Network, one of the nation’s largest networks of integrated, community-based oncology practices.

Woodlands is a physician-owned multispecialty outpatient clinic serving Florida’s Panhandle region. We have 22 specialized physicians and 10 advanced practice providers, including medical and radiation oncologists, urologists, primary care physicians, and an OB/GYN. We formed the practice 10 years ago when the group of urologists I was part of merged with a medical oncology group. The union was a win-win for both practices. We invested in building a 76,000 square foot facility to provide most of the services our patients needed, and over the years we have built a medical practice that is very unique and special in our area. Although it has been a struggle, we have been successful thanks to our knowledgeable administration that has navigated us through this difficult climate.

Just like other independent practices our size, succeeding has been an ongoing challenge in an environment with declining reimbursements and increasing costs. We also face a host of other issues. For instance, it is very difficult to compete against some of the larger hospitals, especially in the area of physician recruitment. Hospital systems offer higher reimbursement opportunities because of their access to capital. Additionally, it is difficult to find entrepreneurial young doctors who want to participate in ownership.

Collaboration With The US Oncology Network

With value-based care coming to the forefront, we are confronting even more challenges. We need capital to invest in critical resources required for new care and reimbursement models, especially analytic technologies. We also need better access to reasonably priced oncology drugs. Growing regulations and escalating costs have made securing these lifesaving drugs for our patients an ongoing battle.We considered many avenues to raise needed capital and address other concerns, and we finally decided expansion would be our best option. Just as we began looking for a solution that would meet our needs, we were approached by The US Oncology Network. They were interested in expanding their footprint in Florida and were attracted to our business model for multispecialty care. During our discussions, they presented an affiliation arrangement that was exactly what we were seeking—a collaboration and not a takeover.

I am fortunate to be with a group of doctors where patient care comes first, and independence is a close second. We feel the best patient care comes from doctors treating patients independently without third party intervention dictating quantity over quality. When we met with The US Oncology Network and learned more about what they were offering, we felt extremely lucky to have found this opportunity. Becoming an affiliate of The Network was exactly what we were hoping for, as it gives us the chance to work with an organization with tremendous resources and expertise while retaining our autonomy to provide the patient-centered care that is at the very heart of what we do.

As an affiliate, we gain access to a wide range of benefits that will keep us strong and independent for years to come. We can tap into needed capital and critical resources that will strengthen and broaden our capabilities in many operational and clinical areas. For example, our ability to compete will be enhanced. While we have no problem competing with hospitals on quality of care, we cannot match their pricing. Joining The Network gives us buying power, which will be extremely helpful in obtaining cost-effective oncology drugs.

Other benefits will also be realized. The Network has a huge recruitment arm which will be a great asset. Teaming up with a large prestigious organization like The Network makes us more attractive to young doctors, as well as enhancing our image within the medical community. Additionally, we gain access to hundreds of cutting-edge clinical trials so we can offer our patients advanced treatments here in our local community. We are also excited about collaborating with the several hundred urologists who recently became associated with The Network through the acquisition of Vantage Oncology. As a practicing urologist, I believe access to this large group of urologists will give us tremendous opportunities to advance urologic care.

The Network Also Benefits

The expertise we are gaining in value-based care and practice management also played a role in our decision to join The Network. Our primary care doctors are already in conversations with The Network about value-based care requirements and expanding into ACOs, which are in their infancy in our region. The Network will also be using their analytic expertise and technologies to tell us where populations are located that need our services, guiding our future growth in the region.The US Oncology Network also gains from the collaboration by adding Woodlands’ 22 specialized physicians to their organization and having the opportunity to work with an authentic multidisciplinary group. The Network is especially interested in learning more about primary care, which is a major part of Woodland’s business. They also extend their reach, broadening and strengthening the capabilities and knowledge- base of their organization throughout the Panhandle region.

Although it is hard to admit, independent practices must grow to survive. There is still a role for independent physicians, as they truly do provide the best medicine we can offer today. However, today’s complex environment has become overwhelming for small practices. One reason we joined The Network was to get bigger faster. Getting bigger provides some security, but practices must be careful to seek out the right group for their growth strategy. It is critical not to lose sight of quality care as the physician’s first goal, and staying true to core values is essential. Our decision to join The Network meets our growth criteria—it allows us to hold true to our values while helping us thrive in today’s evolving healthcare landscape.