news story / By Japhet Weeks

Group Therapy

St. Joe’s prescription for HumCo’s shrinking doc pop

(Dec. 20, 2007)  One day in the not-too-distant future, Humboldt County’s anemic medical community might be on the operating table, with the area’s few remaining doctors trying to figure out how to revive it. According to Dr. Ellen Mahoney, former president of the Humboldt-Del Norte Medical Society, the county will have 40 fewer physicians within the next five to 10 years — that is, unless something is done soon.

In 2006, Mahoney gathered together about 70 health providers, mostly physicians, to brainstorm. That group’s recommendations, summarized in a 2006 report by Mahoney, focused on integrating doctors’ practices into a large group that would stand on an equal footing with the hospitals, while remaining separate from them. But the project fell through for lack of money.

GALLERY >

Now St. Joseph Hospital has proposed a similar course of action. It wants to create a multi-specialty group practice in Humboldt County that will eventually include 40 physicians representing 10 different medical specialties. The proposed practice, which would be run by a nonprofit foundation, combines the expertise of hospital administrators, who handle the financial side of things, with specialists, who, unencumbered by running their own practice, can focus on patients.

But because of St. Joe’s track record — a fateful mix of bad business decisions and a sometimes combative attitude toward local physicians — some doctors are wary of letting the hospital take the reins on a project of this magnitude.

On Monday the Journal sat down with Joe Mark, CEO of St. Joseph Hospital. Mark, a solidly built Midwesterner with cleanly trimmed silver hair and a dark suit, explained the multi-specialty group as “primarily a recruitment and retention strategy to keep good doctors here and bring new ones in.”

Mark originally moved to Eureka in 2005 from Ohio on what he called “a six month consulting arrangement.” He was brought in to clean up St. Joe’s mess. The hospital was hemorrhaging money and already heavily in debt as a result of a string of bad business decisions, like buying up doctor’s clinics and starting its own radiology center in competition with the already-existing team of local radiologists. Mark is credited with saving the hospital, one of 14 in the state run by the Catholic Sisters of Orange. Now, Mark has no plans to leave. He loves it here, and there’s a lot of work to be done.

For the moment, setting up the multi-specialty group is high on Mark’s list of priorities. There are a lot of small practices in the county, he said, and that means that each of them carries a lot of overhead. That’s why, according to him, “there’s really no economy of scale.” Which is where the hospital-affiliated foundation can help. It will effectively buy up doctors’ assets and subsidize their practices. Once a part of the group, the doctors will run it, 50-50, with the foundation.

As for recruiting, the multi-specialty group can offer trainees, who typically leave residency with $100,000-$200,000 in debt, what they’re looking for in a competitive market: a steady stream of income, someone to do their billing for them and reasonable hours.

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