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Don’t regulate independent physicians off map



Hospitals have been on a shopping spree. In the last two years, they’ve acquired nearly 3,000 physician practices, according to new research from the Physicians Advocacy Institute.

Some physicians — myself included — prefer to remain independent. We have found that only in an independent setting can we deliver the kind of patient-centered care that drew us into medicine.

To stay independent, some physician groups are partnering with “management services organizations.” These entities offer physicians access to the medical resources and capital they need to compete against hospital systems, resist acquisition, and most importantly, provide top-notch care.

Unfortunately, the MSO model is under attack. Some lawmakers do not like the fact that private equity firms typically provide financial support to MSOs. So these lawmakers are trying to ban independent physician groups from teaming up with them.

That would be disastrous for the patients we serve.

Consider what my practice has been able to do for our patients since partnering with Gastro Health, an MSO with affiliated gastroenterology practices in seven states, just two years ago.

We have gained access to data analytics and artificial intelligence tools we never could have deployed on our own, as a 10-physician practice in Framingham. These capabilities allow us to improve our polyp detection rates — and reduce the incidence of colon cancer.

In addition, these new tech tools can analyze patient medical records to ensure immune-suppressed patients are up to date on their vaccines — and thus protected from preventable disease.

We are using data analytics to screen the records of patients with ulcerative colitis to make sure they’re receiving colonoscopies every two years, in line with the standard of care. Previously, my colleagues and I had to rely on patients remembering to book those biannual procedures — or cross-reference charts for thousands of patients manually.

Our MSO partner has also opened up the world of clinical trials to our patients. Researchers are willing to work with us because we are part of a network of some 400 gastroenterologists across the country. That scale makes high-level medical research possible.

The upshot is that our patients can now receive access to cutting-edge procedures and medications at our offices, just minutes from their homes. Previously, they would have had to travel to an academic medical center in Boston or Worcester — if they were fortunate enough to be admitted to the trial.

For example, our patients have gained access to experimental therapies for fatty liver disease, a leading cause of cirrhosis that is reaching epidemic levels. The first treatment for one form of the disease was just approved by regulators this year. Our patients helped provide the evidence base for other novel therapies that are now awaiting approval.

Teaming up with an MSO has also allowed us to offer our patients more innovative models of care.

Some patients with irritable bowel syndrome can respond as well to a treatment regimen of diet and cognitive behavioral therapy as to medication. Our practice does not have the mental health providers to deliver such therapy, and waits for in-person care are often long.

Through other gastroenterologists in our MSO’s network, we recently learned about a digital cognitive behavioral therapy platform called Mahana geared exclusively toward patients with IBS.

Pre-MSO, we might not have known about this platform — much less have been able to provide our patients seamless access to it.

I understand lawmakers’ concerns about the impact of private equity on health care, especially given some of the recent controversy about the closure of Steward Health Care facilities here in Massachusetts.

But the physicians in our practice — and our patients — have only seen care improve since we teamed up with a private equity-backed MSO.

In fact, we have been able to expand access to care thanks to the financial backing of private equity. We’ve brought on new physicians, physician assistants, and nurse practitioners throughout Middlesex County at our practices in Framingham, Acton, and Chelmsford.

All of our practices accept MassHealth, and we also provide care to patients from some of the most underserved parts of the state, including patients from Lowell and Lawrence.

When we were recruiting doctors on our own, it took us nearly two years to hire one. Our MSO has helped us cut that timeframe to just a few months.

Patients benefit when they can choose where to receive care — whether at a hospital or at an independent practice. Such choice and competition lead to better-quality, more accessible care at lower cost.

MSO partnerships enable independent practices to stay that way. Our leaders must not regulate them out of existence.

Dr. George Dickstein is a gastroenterologist with Gastro Health in Framingham.

 



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