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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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