A change of heart: Cardiologists leaving private practices for hospitals

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Published February 13, 2012

| FoxNews.com

A weakened economy, combined with dwindling insurance payouts and rising costs, has driven a growing number of cardiologists to pack up their stethoscopes and leave their private practices behind to operate as hospital employees.

Cardiologists are feeling the brunt of a health care system, they say, is in cardiac arrest.

"We had gotten to the point where, I think, a lot of us believed that we could not continue to deliver the quality of care that we wanted," Dr. Audrey Sernyak, an interventional cardiologist at Our Lady of Lourdes Medical Center in Camden, N.J., tells Fox News.

"We had cut back so much in our office staff, and our ability to serve our patients, and so much of our time was being devoted to worrying about paying the bills and worrying about running our small business rather than worrying about our patients. That was not a model that was sustainable for us."

According to the American College of Cardiology (ACC), more than half of all cardiology private practices in the U.S. have recently made major cuts to their budget or shut their doors altogether, with 40 percent choosing instead to work for a hospital -- a switch physicians say increases quality of care.

"We don't want to be driven to do more procedures to make more money and that's clearly a negative," explains Dr. Art Martella, the chief of cardiothoracic surgery at Our Lady of Lourdes Medical Center. "We want to be incentivized to ultimately provide good care for the patient, and if the cardiology end of my group is successful, then I'll be successful."

The ACC claims more uninsured Americans, cuts to Medicare reimbursement and an aging population have made private practice unsustainable.

But ACC CEO Dr. Jack Lewin says these changes will need to be closely monitored. Lewin adds, "There is a little concern that when a physician is employed by a non-physician entity that they are no longer the unfettered advocate of the patient necessarily. They're working for a boss who may drive things in a different direction. I don't think that's happening right now, but we don't know where this goes in the future. We don't know, in fact, if doctors will move out of a hospital, five years from now, depending on how the economics change, but it's a dramatic change to have the majority of cardiologists now moving into hospital employment and out of private practice."

Alexander J. Hatala, President & CEO of the Lourdes Health System, says it has employed and partnered with almost 50 cardiologists over the last year.

"The cardiologists actually not only participate in the care, they drive the change. So, in fact, when you think about the old system, the old system is that we basically partnered together but had different motivations as organizations as physicians and hospitals -- always the focus is the patient -- but we were never aligned totally. Now, we're basically connected at the hip and so the physicians actually are driving the clinical change. We're saying to them, 'You go ahead and do it. You know cardiology better than anybody else. You're smart physicians you're bright people and figure out a better way to do it.' And they are going about and doing that in a very rapid way."

While some patients may worry they won't have the same relationships they used to have with their doctors, experts say this trend isn't going away anytime soon and the hospital of the future will be a place you go not just when you are sick, but also where you go when you are well.

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http://www.foxnews.com/health/2012/02/13/change-heart-cardiologists-leaving-private-practices-for-hospitals/