Practice-Based Hematology
The practice landscape may
be changing, but there is
always one constant: ASH is
here to help you face these
challenges. The Society is
dedicated to meeting the
needs of its clinical community; below are some of the
efforts currently underway:
ASH Practice Partnership (APP)
The APP is a network within the Society
that was formed to represent the interests
of practicing hematologists.
APP Lunch at this year’s
annual meeting
The topic of this year’s presentation is
“Whither the Practice of Hematology in
an Era of Mergers?” (Sunday, December 7,
11:15 a.m.), and will feature remarks from
Alice Gosfield, Esq., and Andrew Pecora,
MD, an attorney and physician who have
been involved with mergers. Led by chair
Steven Allen, MD, this session will focus
on the challenges associated with mergers
between traditional community-based
private practices and larger health-care
systems.
Drug Resources Web Page
ASH has developed a Web page focused
on improving access to high-cost drugs,
including names and contacts for patient
assistance programs, sample appeal letters
for high-cost hematologic drugs, and upto-date information on hematologic drug
shortages. (Read more about the Drug
Resources Web page in ASH Directions on
page 13.)
ASH Resources for Clinicians
The Society has created materials covering
changing practice and workforce issues
that impact hematologists, such as the
transition to the ICD-10 diagnosis system,
the Medicare Physician Quality Reporting
system, and the Sunshine Act data release.
Access these resources at
www.hematology.org/Clinicians.
New Payment Models
ASH is currently developing policy on
the role of new payment models for
hematologic illness including both
malignant and non-malignant disease.
looking to retire now, and they
are finding it difficult to find his
replacement.
“In our practice, my partner
and I have been working every
other weekend for years — nobody is going to accept a job like
that,” Dr. Kleinerman said. “People
coming out of training now have
different expectations in terms of
personal time.”
Dr. Kleinerman said that she
and her partner have asked their
affiliated hospital for assistance,
even going so far as to take a pay
cut to finance their search, but are
having little luck.
Kenneth Adler, MD, is a
practicing hematologist at Regional
Cancer Care Associates in New
Jersey, one of the largest oncology
physician networks in the country.
Dr. Adler said that his practice has
recently hired two physicians, but
that he was beginning to notice an
interesting trend among applicants.
“We received about 30 to 40
applications for each position – our
practice is in a desirable place to
live and raise a family. However,
only a few of the applicants were
graduates from American medical
schools,” Dr. Adler noted. “American graduates are graduating with
debt and seem to not be choosing
to go into cognitive specialties like
hematology, but rather gravitating
to procedure-based specialties.”
Drs. Adler and Allen both
agreed that something needs to be
done to try to engage more medical
students in the field of hematology, and ASH has definitely made
that one of its short- and long-term
goals, Dr. Allen said.
“Even among those who go into
hematology/oncology fellowship,
many trainees trend toward solid
tumors and shy away from hematology because it is a challenging and
difficult field,” Dr. Allen said. “ASH
needs to emphasize the satisfaction
that can be achieved by taking care
of patients with these fascinating
and challenging conditions.”
Landscape of Mergers
As chair of ASH’s COP, Dr. Allen said
he had noticed a new trend emerging
even among the COP members in recent years: More members are affiliating with a hospital or with a non-hospital large physician group. The results
of the recent survey seem to confirm
this trend on a national basis.
68
ASH Clinical News
Results indicated that:
• 47 percent of respondents
work for a practice owned by
an academic medical center
• 25 percent worked for a
community-based private
practice not owned by a
hospital or larger entity
• 19 percent worked for a
hospital-based practice at a
non-academic medical center
• 9 percent worked for a practice
owned by a large, non-hospital
entity
In Dr. Adler’s case, the hematology practice that he and a partner
started in northern New Jersey in
1978 enjoyed several years of success, growing to include 12 hematologists/oncologists. Eventually,
though, the practice could no longer
financially sustain itself. Dr. Adler’s
practice became a part of Regional
Cancer Care Associates – a group
that spans the length of New Jersey
from Hackensack to Cape May.
“We were busy, but reimbursement plummeted, overhead went
up, and revenues dropped,” Dr.
Adler said of the decision to merge.
Dr. Kleinerman’s small private
practice was located in a medical
office building associated with a
“n the near future, there is going
I
to be a manpower crisis ...
Demands on the remaining
practitioners and the patient
loads are going to increase.”
—STEVEN ALLEN, MD
More than half of the hematologists who had practices other than
community-based private practices indicated that their practice
is affiliated with a larger practice,
hospital, academic medical center,
or health-care system. That number is only expected to increase:
18 percent of respondents from
community-based private practices indicated that their practice
is planning to merge with or be
acquired by a larger practice,
hospital, academic medical center,
or health-care system in the next
three years.
Dr. Adler pointed out that with
the average survey respondent
having completed training 17 years
ago, this survey may have failed to
capture younger trainees, or that
such a high number of resp