Space Sharing Allows Coordinated Care, Cost Savings

The current health-care environment is creating many new challengesfor physicians, and addressing these challenges has led to newideas in office practice management.

To meet the managed care challenge, my own medical oncology practice,the Metropolitan Oncology Medical Group, Los Angeles, has formedan alliance with a hospital-based radiotherapist, Armand Bouzaglou,MD, to develop an outpatient facility utilizing a concept we call"space sharing."

Our medical oncology group has leased office space within a 7,500square foot suite owned by St. Vincent Medical Center, Los Angeles.Roughly one third of the space is dedicated to a hospital-based,outpatient radiation therapy department, which is headed by Dr.Bouzaglou.

We have signed an exclusive contract with Dr. Bouzaglou to provideradiotherapy professional services for our patients. His departmentis staffed by St. Vincent Medical Center, with which I am alsoaffiliated.

The medical oncology group's staff, work areas, infusion room,and inventory are completely independent of the hospital space.However, the two practices share a common waiting room, entryway,employee lunch room, patient library, and conference room. Useof the complex's seven examination rooms is often "shared"on an as-needed basis.

Overall, we are trying to provide a full service outpatient facilityin a community office setting. As much as possible, we offer comparableservices to our managed care and our fee-for-service patients.

The result of this marriage is that all of the space is utilizedmore efficiently at a tremendous cost savings to both specialties.It has also fostered a collegial atmosphere. The large conferencearea is open for discussions with patients, family, involved treatmentspecialists, and the primary care physician.

The available space has enabled us to invite "superspecialists,"including experts in pain control, cancer-related mouth care,and gynecologic oncology, to see patients on site. Hospital-employeddietitians, pastoral care representatives, social service personnel,and a clinical pharmacist have been invited to the office complexto give lectures and to provide individual and group consultations.

The patient library is operated by a trained auxiliary volunteer.Like all the described services, it is open to any cancer patientin the medical community.

The response to the program has been tremendous; the health-careprofessionals, payers, and patients have all realized huge benefitsfrom the coordinated care.

Phase II of the concept will be the construction of a separateentrance for the outpatient cancer center and the provision ofseparate office space for the hospital support personnel and subspecialtyphysicians.

We hope that the availability of these services will be appealingto other oncol-ogists in the community. We would like to be ableto provide them with office space and a dedicated infusion area.

Dr. Kennedy is a medical oncologist with the Metropolitan OncologyMedical Group, Inc., Los Angeles.

Dr. Presant is president, California Cancer Medical Center, WestCovina.

Mommy AlwaysTaught Me to Share!

By Cary A. Presant, MD ,Series Editor

In today's environment of reduced payer reimbursement, Mommy wasright about the rewards of sharing--if not our toys, then at leastour space!

It has often been difficult for oncologists to reduce overheadexpenses without reducing needed services. At St. Vincent MedicalCenter, Dr. Kennedy, a medical oncologist, and Dr. Bouzaglou,a radiation therapist, have worked with the hospital to createa "cancer center" environment for patients.

The space was constructed to specifically allow such sharing soas to reduce overhead expenses. This has been accomplished whileincreasing the availability of quality-enhancing supportive careand consultative services on a shared, part-time basis.

Readers should look to their hospitals for opportunities to createsimilar savings. Higher quality with less expense--it would makea mother proud!