Infusion Centers: Opportunities for Financial and Personal Success by ProQuest


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									                                                     Infusion Centers
                             Opportunities for Financial and Personal Success
                                                             Ronnie J. Garner, MD

I  suspect many of you do not know anything about in-
    fusion centers, but you know a lot about pathology, and
I know a lot about clinical pathology. And I think we have
                                                                           operate, they are generally very proprietary. They are usu-
                                                                           ally managed by oncology or rheumatology. Most of these
                                                                           infusion centers service their own physician groups. They
an opportunity now to perhaps expand our role as direc-                    have limited services and hours. They will do some ad-
tors of infusion centers.                                                  ditional services but not much and not necessarily con-
   There have been many seminal changes in the delivery                    venient or timely for the patient. They usually do not have
of health care, at least in the hospital system where I work.              a physician on site and it is typically nurse managed.
I know that for those of you who practice in commercial                       This leaves, again in my opinion, and I think I have
centers, much of this will not be applicable. In Presbyte-                 proved it by the growth of our infusion center, many phy-
rian Hospital (Albuquerque, New Mexico), hospitalists ad-                  sicians in the community who need infusion services or
mit and manage most hospital admissions and this was                       services that can be provided in an infusion center that
done as a quality measure. The role of internists and pri-                 can be managed by pathology and, particularly, a clinical
mary care has changed and is in transition. My personal                    pathologist. Internal medicine, family practice, obstetric-
opinion is that internal medicine is in crisis and this is                 gynecology, all of these specialists need services that can
really not good for hospitals. Additionally, most physi-                   be provide in an infusion center.
cians now practice in managed care situations with pro-                       Currently in most communities there is a limited avail-
ductivity goals that are directed by office practice man-                   ability of what I call generic or nondenominational or non-
agers that schedule patients to be seen every 10 minutes                   proprietary infusion centers. Most community physicians
or every 15 minutes. There is increased government reg-                    do not have many choices about where to send patients
ulation, which increasingly impacts the practice of medi-                  for medical infusions or other services. They can send
cine and particularly office practice and other areas of                    them to the ERs, admit them to the hospital, which I think
medicine. We constantly need prior authorizations. There                   is an absolute misuse considering how full hospitals are,
is increased overhead and overutilization of emergency                     or try to find an outpatient facility. There are some free-
rooms (ERs) as an alternative ‘‘physician’s office.’’ The                   standing commercial providers and you can get some
trend is to shift a great deal of patient care to outpatient               home health care, if you wish.
services.                                                                     I believe that the current medical environment has pro-
   Hospitals now have tremendous competition, and one                      vided us a tremendous opportunity and by us I mean hos-
of the things that has been a huge problem for hospitals                   pitals and those of us who are hospital-based, clinical pa-
is to see revenue sources being drained by free-standing                   thologists and pathology departments in general. What is
heart centers, surgical centers, or eye centers where you                  this opportunity? I think it is an opportunity to work with
can get a Lasix procedure 
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