IPC–The Hospitalist Company
Perhaps the best-known hospitalist employer, IPC (North Hollywood, Calif.) currently has approximately 500 full-time employed hospitalists and 150-200 part-timers working in more than 200 facilities across 23 U.S. markets.
“We have every type of practice, including academic and small hospitals,” says Adam D. Singer, MD, chairman, CEO, and chief medical officer of IPC. The company was re-incorporated in 1995. “We started accelerating in ’97, and we’ve been growing 30 to 50% per year—steady growth. We’re acquiring like-minded groups. We’ve had 10 acquisitions in the last 24 months. All our acquisitions have to be high-minded, quality groups.”
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PrimeDoc
Based in Asheville, N.C., PrimeDoc is 100% physician-owned and managed. Counting permanent employees as well as independent contractors, the company staffs approximately 110 hospitalists.
“We do things a little differently,” says Robert J. Reynolds, MD, president and CEO, who also co-founded PrimeDoc in 1997. “We started as a freestanding practice serving one hospital, and we use a private practice model today. We’ve grown by establishing private practices in five states along the Atlantic seaboard.”
Dr. Reynolds admits that the PrimeDoc model is not “terribly unique. We contract with hospitals to provide care to unassigned patients, and we solicit referrals from [primary care physicians] in the community.”
TeamHealth Hospital Medicine
Another company that started out providing ED services—as well as administrative and staffing services—TeamHealth (Wilmington, N.C.) now employees more than 400 hospitalists, most of whom are full-time employees.
“Until this past year, I think we’ve been a little bit of a sleeper in hospital medicine,” says Stacy Goldsholl, MD, president. “That’s all changing now, as we’re aggressively pursuing the number-one place in the market. But we’ve grown as a silent presence through our relational reputations—basically, through word of mouth in the emergency departments. We have more than 400 contracts [in emergency medicine].”
The company continues to add hospital medicine programs through several methods. “We set up new programs from scratch, we restructure existing programs, we acquire large hospital medicine groups,” says Dr. Goldsholl, “and we apply things that work in one model to other models.”
Growth Trends
One feature these organizations have in common: explosive growth. The corporations are acquiring, starting, or partnering with a steady stream of hospital medicine programs.
“We’ve more than doubled in the last year,” says Dr. Goldsholl. “Our pipeline for hospital medicine groups is just exploding. We’re trying to manage the growth we have as well as what’s coming. We hope to double again in the next two years.”
Within that increase in programs comes another growth trend: hospital clients are asking their hospital medicine groups to take on more responsibility. “Our role in the hospital setting is definitely expanding,” says Dr. Goldsholl. “And the hospitalist’s role is only going to increase. We’ll see more hospital-based intensivists, surgicalists, and laborists [OB/GYN physicians]—there’s tremendous growth coming.”
Dr. Reynolds agrees. “In 1997, we basically provided medical care for acute care patients,” he explains. “Now we’re providing care for surgical care patients. We do pre-op eval[uation]s and perioperative management. We’ve also seen more demand for rapid response management, and we’re being asked to do pre-op eval[uation]s for outpatient surgeries.”
More hospitals are proactively seeking out these market leaders to explore adding a new hospital medicine program. “We’re getting calls from smaller and smaller hospitals,” says Dr. Reynolds. “Even the smallest hospitals want to implement a hospital medicine program, and it’s difficult to provide 24-hour coverage and have it make sense financially. But the trend is promising: Every hospital wants this type of service.”