“It’s a true merger,” said Mark DeGuenther, MD, president of UCA. “No one practice is buying another. The accountants are determining the value of the groups and we’re truly merging.”
The newly created practice will combine the 16 physicians now at UCA with three at Birmingham-Shelby and five at Eastern Urology to total 24 physicians, bringing the group to a size that offers several advantages.
“We think this will enhance the efficiency of our practice,” DeGuenther said. “We’ll be able to further improve our integrated practice model, doing most diagnostics and treatment in-house, which is more convenient for both the patient and the patient’s employer, since the patient doesn’t have drive around to different locations for tests, which also means less time for them away from work.”
And the combined practice will offer 12 locations, as far north as Winfield and south to Sylacauga. “This will be good for patients,” said Patrick Mills, MD from Birmingham-Shelby Urology. “We’re in Alabaster, and we have a number of patients who work in downtown Birmingham. On countless occasions, we’ll get calls from patients who have an urgent problem. We’re glad to see them, of course, but they have to drive back to Alabaster. Now, if they’re downtown, they can stop by the office in that area. And it may work conversely if someone is near us and needs help.”
Taylor Bragg, MD of Eastern Urology sees additional possibilities. “We’re excited about the research,” he said. “We’ll be able to offer our patients entry into some innovative research programs. And UCA has some specialized clinics that we can take advantage of, allowing us to become more sub-specialized. When I tell my patients I’m going to talk to a couple of my partners about their problem, they appreciate it because it’s like getting a second opinion without having to pay another co-pay. Now, I’ve added 19 more physicians to that equation.”
The physicians at UCA are aware of the problems that have sometimes befallen larger groups and have tried to structure their business in a way that mitigates difficulties. “All the physicians who are partners are members of the board of directors from a legal standpoint, but the day to day operations are handled by David Sorrells, our administrator, and by our president, who is currently myself,” DeGuenther said. “There is an executive board, made up of our medical director and our president, along with four other physicians who are voted on at large. This board is responsible for trying to streamline discussion so we can conduct business efficiently. We think we’ve reached a way to give everyone a voice in things, without bogging us down.” One person from each of the three merging practices will be on the executive board.
In addition to working to keep the business operating smoothly, UCA puts a great deal of emphasis on internal quality control. The practice medical director is responsible for conducting a monthly morbidity/mortality conference that the physicians are required to attend. There is also a monthly educational conference where difficult cases are presented to the urologists. And the practice conducts internal utilization reviews of the physicians.
“We want to make sure people aren’t over utilizing or under utilizing,” DeGuenther said. “There are certain health indicators we want to benchmark. Everyone wants to do outcomes research. If you’re doing good data collection, you can figure out what your best practices are, which is something patients, employers, and insurers want to know about.”
The merger was not something that happened overnight. “We’ve had a great relationship with UCA for years, even though we weren’t in the same practice,” Bragg said. “We’ve talked on and off about this for several years, but really got serious about it in the past year. It’s been well thought through.”
“Our practices all mesh very well in terms of philosophy,” DeGuenther said. “The philosophy of all our practices is that we will take care of all patients who come in the door. We’re obviously in business, so we need to be paid for our services, but we won’t turn patients away for a lack of ability to pay.
“I think the greatest thing about our merger is that the individuals within each entity absolutely trust each other. We’re merging with not just quality physicians, we’re merging with quality people.”