Doctor-run facility expands in Bucks

"When the Comprehensive Breast Care Institute of Bucks County went under last year, the ever-growing Rothman Institute, one of the region's big-name orthopedic physician groups, saw an opportunity.

It snatched up the 120,000-square-foot building and, earlier this year, opened a new orthopedic hospital just before the new health law made it practically impossible to open or expand physician-owned hospitals.

Critics say that such facilities weaken community hospitals by siphoning off the most lucrative patients and that doctors have an incentive to do more expensive procedures when they own the hospital.

Rothman leaders, though, say that they already were attracting many patients from Bucks County and New Jersey and that the newly acquired building in Bensalem will improve patient access.

"This hospital became available, and it's really perfect for our needs," said Matthew Austin, director of joint-replacement services for Rothman.

Mike West, chief executive officer of the 70-physician practice, said some studies found higher quality and patient satisfaction in physician-operated specialty hospitals.

"We felt that this was an opportunity as a physician-owned hospital to be in a position to really drive most of the decisions," he said.

The hospital is having an open house for reporters and community leaders Monday evening to show off the new facility, known officially as the Rothman Institute at Bucks County Specialty Hospital. The building, which is across from PhiladelphiaPark Race Track on Tillman Drive, was originally designed to provide holistic care for patients who needed breast care.

The Rothman practice was founded in 1970 by surgeon Richard Rothman. At 72, he still performs 600 to 700 joint replacements a year, West said. Rothman's best known location is at Thomas Jefferson University Hospital, but it has opened 11 more sites, including several at hospitals in Pennsylvania and New Jersey, since West became CEO 11 years ago. The practice has been adding patients at a rate of about 27 percent a year. Volume has grown at Jefferson, even as the group's tentacles have spread farther into the suburbs.

"The patient base has continued to grow as the city matured over time and people moved back into the city," Austin said.

Half of the space in Bensalem is used by the hospital, which has 24 beds and six operating rooms. The other half of the building is office space. Rothman uses some of that, as does Holy Redeemer Hospital and Medical Center. Rothman wants more tenants.

Nueterra Healthcare of Leawood, Kan., is a partial owner and manager of the new facility. Nueterra manages physician-owned hospitals.

The specialty hospital has a one-bed urgent-care center. The facility will have at least one hospitalist - a doctor who specializes in caring for hospitalized patients - on-site at all times, West said. Rothman will transfer patients who have serious medical complications to Nazareth Hospital, where it also performs surgery. So far, that has not been necessary, Austin said. Patients who need the most complex surgery or who have other significant medical problems will still go to Jefferson for treatment.

The Rothman Institute is based on the premise that surgeons do their best work when they specialize in one type of care, such as hips and knees, or shoulders, or ankles. West and Austin said that improved the quality of care.

West said the Bucks hospital was on track to perform 2,500 surgical and pain-management procedures this year. Within three years, he expects doctors there to do 7,000 to 8,500 procedures a year.

Kenneth Braithwaite, senior vice president of the Delaware Valley Healthcare Council of the Hospital and Healthsystem Association of Pennsylvania, said specialty hospitals such as the one in Bucks tended to provide higher-profit services such as orthopedic, neurological, and cardiac care. They attract patients away from full-service hospitals, which then are not able to use income from the high-paying services to subsidize money-losing care, he said.

"We are adamantly opposed to the specialty hospitals," Braithwaite said.

The health law places strict limits on expansion by physician-owned hospitals that are already open. New hospitals will not be able to participate in the Medicare program unless they have a Medicare provider number by the end of this year.

Physician Hospitals of America, a trade group, said the health bill would have a "devastating impact" on its members.

Patrick Knaus, senior vice president for strategy and business development for St. Mary Medical Center, said it was too soon to tell how his hospital, which has 26 orthopedic surgeons on staff and is about eight miles away, will be affected by the new Rothman facility. Thanks in part to an aging baby boomer population, orthopedic business at the hospital has risen 5 percent so far this year.

"Orthopedics is our fastest-growing service line over the past five years," he said.

He said he was not worrying about Rothman, which has always drawn patients from St. Mary's service area. "What we try to do is really focus on building the best program we can," he said."