Hospital system brings practices back to campus

In their pursuit of visibility and accessibility, physicians have been known over the years to move out from the shadow of hospitals. Rather than lease space on the fourth floor of a nondescript office building, doctors have moved to less-traditional locations, like strip malls, renovated grocery stores, or their own freestanding buildings.

The power of a hospital reputation, however, can still play an important role in physician location, as one Louisville, Ky.-based health system has shown.

Norton Audubon Hospital, which was acquired by Norton Healthcare in 1998, has gradually reeled physicians back to its campus with a strategy of concentrating on primary care and rebuilding confidence among patients in the community. A medical office building opened last spring on its campus is already 75% full, adding to an already existing building that is almost completely occupied.

Between physicians joining Community Medical Associates, Norton's physician network, and relocating their private practices, Norton Audubon Hospital has seen dozens of doctors move to its campus over the last few years.

The hospital's vital statistics, not surprisingly, have followed suit. The facility's census, which was typically in the 150-patient range when Norton took over, was 281 one day last month, said Tom Kmetz, president and administrator of the hospital.

At the time Norton acquired Audubon, "it was a depleted hospital," Kmetz said. "We really spent the first three years building confidence in the community and medical staff," he said. "We had to show them we were serious about returning to a position of strength. We invested heavily in equipment, facilities and operations."

Once hospital officials felt its reputation had grown, it looked to bring doctors back to the campus through new office construction. The recently completed building is only the first of two planned phases of construction, Kmetz said.

Using office construction to keep physicians on campus is a common strategy, but "it's probably picked up steam as relationships between doctors and hospitals have changed," said Rick Wade, a spokesman for the American Hospital Assn. Recent developments have included separate all-inclusive buildings for distinct services, such as a women's and children's pavilion, which contain physician offices and hospital services under one roof, Wade said.

At Norton Audubon, physicians have played a unique role in the hospital's resurgence. After buying into Norton's strategy, their migration to the campus has contributed to the hospital's success.

Louise Box, MD, a general practice physician, said she and three associates recently moved to the Norton Audubon campus last month. Being so intimately associated with the hospital may not have been as attractive an option a few years ago, but between Norton's business oversight and the chance to be so close to the hospital, it seemed like a natural decision at this time, she said.

With compensation plans based on productivity, even employed physicians have to be conscious of where they are practicing and what their patients will think, Dr. Box said.

"It's important to be able to pull patients with you, and you want them to feel positive," she said.

Ginger Figg, vice president and executive director of Norton Healthcare Physician Services, said physician recruiting has been easier in recent years, thanks both to the quality of current employed doctors and the reputation of the health system.

"We really don't aggressively pursue physicians, and we don't use national recruiters either," she said. "There's a lot of knowledge about us in the local medical community."