MINUTES

Attending:

John Rutherford, MB.ChB.
Gary Reed, M.D.
Steven Leach, M.D.
Shelley Roaten, M.D.
Stacey Rychtyk, RN
Mary Teasley, RN
Terri Bohuslav
Judye Gremm
Cindy Lochte
Julie Landesberg

Absent:

Gregory Schneider, M.D.
Ellen Wilson, M.D.

Dr. Reed began the discussion by noting that some of the primary care faculty are “burning out” because they are being asked to take on too many patients.  They feel guilty if they do not accept a new patient that a colleague is asking them to see.  The faculty member discussed has a very full practice, but continues to have colleagues referring patients.  Dr. Rutherford felt that primary care physicians who have “closed” their practices must be able to communicate that themselves and then have the capacity to recommend a primary care colleague who could assume the care for the patient being referred.  Dr Rutherford feels that it is still prudent to restrict the primary care practice (life-long) to a geographic boundary.  Patients living far away may still want to visit our primary care MDs however they should have a local primary care MD as well. Dr. Reed acknowledged that they do provide a lot of telephone care to outlying patients.  This takes a good deal of time and is work that is not billed. Dr. Leach discussed the External Advisory Panel’s recommendation of building relationships with community primary care physicians to whom we could refer outlying patients.    It was suggested that there is always the option for GIM to work in concert with Family Medicine.  Patients could be referred to that practice. It was agreed that we need to build a consensus with our faculty on the primary care practice limitations.  The alternative is to plan and anticipate growth and hire faculty accordingly. 

Tasks: 

1) Stacey Rychtyk will work with Terri Bohuslav and the Corporation to produce a report that will show us the geographic locations of the current patient base.  

2) A letter will be prepared to Southwestern’s faculty to explain Primary Care’s plan for providing care given the limited resources.

Dr. Reed provided the Task Force with the RVU report for his practice.  The report made him ask some specific questions about his personal practice.

1)  Is he under billing?
2) Is he providing enough appointment times for patients?
3) Are his patient’s healthier that those of other physicians?
4) Is he providing more phone care (time not being billed) that visit time with  patients? 

He observed that he rarely charges for a “health maintenance visit” when it is the applicable designation – it pays more to the physician.  He noted that he needs to review and learn various billing levels and get more familiar with what he can bill for.
It was suggested that it would be helpful to see the level of billings on the scorecard report. 

Dr. Rutherford plans to schedule a meeting to include Drs. Rutherford, Reed, Leach, and Willett to review the RVU report on the scorecard.

Dr. Leach has a friend, Mike Phillips, who teaches team building techniques.  He said that Mr. Bill Solomon provides this in his business.  Dr. Leach will schedule a time when Mr. Phillips can come and discuss his program.