Doctors Split from Hospital System... How'd They Do It??

The Story of Tryon Medical Partners shows us that if doctors don't like the way a hospital is running their practice, they can leave and be successful.
Specifically, the 88 mostly primary care doctors of Tryon Medical Partners sued Atrium Health, the hospital system that owned them, in order to leave and become independent in 2018.
Some of their grievances against the hospital system were:
1. The hospital replaced the nurses in their clinics with medical assistants.
2. The hospital increased the number of patients they needed to see per day and decreased their visit times.
3. The hospital increased the size of their non-compete agreement from 15 miles to 30.
Atrium agreed to let the doctors separate in exchange for dropping the lawsuit.
Just one year later Tryon Medical Partners began to offer Direct Primary Care to local employers and have since signed up 30 companies.
The program has been a huge success because an independent primary care practice can work to provide better care at lower costs. Conversely, physicians associated with a hospital system are incentivized to increase healthcare costs.
Sources:
www.fiercehealthcare.com/prac...
charlotte.axios.com/121955/br...
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[@JQPOINT]

Good for them. As a physician /GI in pvt. practice, I can see the huge advantage of NOT being beholden to suits., taking charge of costs, personnel and using time and money effectively. At least these doctors were smart to learn from their mistakes

[@ahealthcarez]

Thank you for watching and sharing your thoughts.

[@NarcoCrew]

Thank you so much for going into private practice and taking that risk. My GI doctor abandoned me because he left the dumb hospital system he was working for. I’m happy for him but goodness what about me????

[@tictac9074]

Great video and fascinating for me, I was a mid-level employed by CHC at the time of the atrium transition as well as a patient of the old Mecklenburg medical group you speak of on this video. Now moved out of the area but very proud of what they did!

[@ahealthcarez]

Thank you for your perspective. Appreciate you watching.

[@patning]

Thank you so much for this video! DPC is the future! For med students interested in primary care and especially DPC, could I please ask you, would you recommend going through IM or FM? Not interested in fellowships. In general, but I realize there are many exceptions, my understanding is: * IM is stronger on sicker and more complex patients and inpatient medicine than FM. So you’d be able to manage the disease progression better without needing to refer out or refer as often maybe. Although some full spectrum unopposed FM programs like JPS in DFW seem strong here too. * IM doesn’t seem to learn many outpatient / office type procedures, whereas these procedures seem built into FM. But maybe IM primary care track programs are good here too. And I’ve heard you can always learn most of these procedures after residency anyway (e.g. workshops). * IM has no peds/OB. But I don’t think most FM PCPs do much OB anyway. Maybe only the really rural ones. Personally speaking, I’m neutral on peds/OB. I don’t mind peds/OB, but I don’t absolutely love them either. * IM seems to be more respected or prestigious than FM. But not sure how much respect or prestige should matter. I have had some attendings tell me, don’t do FM (or even PCP), you’ll be overworked and you won’t make as much money, you should do IM then a fellowship in gi, cards, pccm, hem/onc, or a/i. But I really like PCP and don’t want to do a fellowship. I like general adult medicine. * FM also seems to have more derm, ortho/msk, ophtho, etc. training than IM.

[@ahealthcarez]

Great question. Majority of DPC docs are FM. Better choice IMO.

[@NickArcade]

I worked as a standardized patient in a medical school, and the med students were only given 14 minutes in an encounter. Lots of them end up running out of time mid-encounter. I feel like they're only given 14 minutes because of the orders of insurance.

[@ahealthcarez]

Not a direct order, but the consequence of Fee-for-Service. Thank you for sharing.

[@NickArcade]

@@ahealthcarez That's really interesting. I have a private physician I pay out of pocket for, and the longest encounter we had was about an hour and a half. Honestly, it was worth the money

[@TheTrueKat]

True!

[@satyaprabhu6207]

Good information sir......

[@ahealthcarez]

Thank you for watching.

[@chasedave]

I sincerely applaud them for their courage. What they did is incredibly important and a model. Unfortunately, for employers, they shifted their primary focus to Medicare Advantage -- i.e., the easy money in primary care. Few have advocated more (including increasing pay) than I have for primary care (that don't have a dog in the fight) but they priced themselves out of the market for employers with working middle class employer bases. Hopefully, as they get themselves on sound financial footing leveraging Medicare, they can revisit employer pricing. Primary care practices can do very well charging $70-75 PMPM (or less in many cases) vs. $90+ PMPM. If pricing has changed, I'm happy to stand corrected.

[@ahealthcarez]

Thank you for watching and for your feedback, Dave.

[@mylifehadi]

Thank you Dr. I am interested in Healthcare Finance; is it possible to conduct a session explaining healthcare funance terminology and basic concepts ? How does insurance work ? What is CRM ? Capital vs Operational budgets ...etc. Thank you

[@ahealthcarez]

Great questions. I have made videos on that: 1. Basics: kzbin.info/www/bejne/qoKYkoVtZs94rsU 2. Health Insurance: kzbin.info/www/bejne/nnTQn2Cjhp2fd6s 3. Prescription coverage and PBMs: kzbin.info/www/bejne/Y6mrY4Vug79nprc 4. Cause of high healthcare costs: kzbin.info/www/bejne/pZC0lY2ee7R-qJY

[@stinksterrekerinski4450]

The hidden long arm of corporate greed.

[@ahealthcarez]

Thank you for your comment.

[@sanadbenali6993]

What is the best model to pay for primary care

[@ahealthcarez]

Full-Risk Capitation as is used by ChenMed, Oak Street, etc.

[@jihyelee7140]

Can you explain the fee model for the tryon medical partners? What are other ways besides fee for service model?

[@ahealthcarez]

Great question. Monthly subscription.

[@jihyelee7140]

@@ahealthcarez is it more profitable for the doctors to do a monthly subscription? I don’t get how this model would be more profitable for the medical partners

[@stinksterrekerinski4450]

15 minutes in primary care wont fly.

[@ahealthcarez]

#Agreed. Thank you for watching!

[@loripigeon2338]

I hope to see more of the old time Primary care run practices. The “cheese cake factory “ phenomenon may work in some areas but not primary care. Would be interested if they measured patient AND provider satisfaction pre and post

[@ahealthcarez]

Great point. Thank you for watching.

[@sanadbenali6993]

Wait so this new entity they made Is it the same as atrium but smaller

[@ahealthcarez]

Great question. No. It is a separate physician practice with 8 clinic locations.