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Health Care Tour: “Seeking Patient-Centered Care”
Lunch with Dr. Hueston Hobbs in Union, SC
The Issue:
- Doctor Hobbs closed his OB/GYN practice in April 2006 because it was losing money. Independent physicians and rural communities face extra challenges in providing health care.
Findings:
- Dr. Hueston Hobbs decided to close his practice for a number of reasons.
- Regulatory mandates burden small practices with small staffs. They still must have a compliance officer, regulation control officer, etc. OSHA and HIPPA, require the same logs and training for small practices as they do for larger practices.
- Billing had been a costly factor. “It takes time just to get someone on the phone.” Codes and procedures change routinely, requiring additional training.
- Decreasing reimbursement by all payers - “In a small environment like this there is no negotiating with insurance. Fees are dictated to small practices or ‘solo docs.’”
- In his final year of practice Dr. Hobbs had $0 personal income.
- Malpractice insurance rates in SC were the straw that broke the camel’s back. Dr. Hobbs’ upcoming renewal was increasing from $35k to $60k. He had never been sued for malpractice.
- Emily Hill and husband Dr. Kenneth Hill (orthopedic surgeon) have been in Union for 7 years. Dr. Hill was incurring $50k in debt per year with medical contracts and a patient mix that was non-profitable.
- Rural areas struggle to get doctors.
- Emily Hill’s husband once served as the only orthopedic surgeon in a 3-county area in Virginia.
- Rural communities do not have sufficient volume to support specialists.
- Carolina Medical now manages the local hospital and is able to recruit from a larger pool of physicians.
When: March 20, 2008
Where: Union, S.C.
Attendees: Hueston Hobbs, MD, Emily Hill (Immediate past president of the SC Medical Alliance Assoc., Member of the Legislative Committee of the AMA Alliance Assoc.).