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[March 16, 2014]
Ventura County doctors go on defense against UCLA Health expansion [Ventura County Star, Calif. :: ]
(Ventura County Star (CA) Via Acquire Media NewsEdge) March 16--East Ventura County doctors in small and solo practices are banding together to compete with large, expanding health systems, including a UCLA network that is growing aggressively.
"Their intention is to take as many patients as possible," said Dr. Bader Iqbal, a family doctor in Thousand Oaks, referring to a UCLA expansion that has brought clinics to Westlake Village, Thousand Oaks, Porter Ranch and Santa Clarita, with more to come.
The doctors say the push typifies a national trend accelerated by the Affordable Care Act in which large health systems buy out private practices and expand. Their response was to form a loosely affiliated network called Choice Health Care Associates.
In the association, doctors practice independently but use their combined resources to advertise themselves. The group has more than 100 primary-care doctors and specialists, making referrals and prompt appointments easier, the physicians say.
They say the network is designed to help them survive.
"We felt health care institutions were coming in and basically trying to recruit private physicians and forcing them to sell out their practices by giving them offers they potentially could not refuse," said Dr. Gilbert Simoni, a Thousand Oaks gastroenterologist.
Doctors said they worry about the growth of not just UCLA but also of many other large systems, including Cedars-Sinai, Providence, Kaiser Permanente and even safety net systems that get government funding such as the Ventura County Health Care Agency and Clinicas del Camino Real.
Large systems have grown for years in a trend magnified by the federal health care overhaul, said David Auerbach, a health care economist and Boston researcher with the Rand Corp. think tank.
"If you're a larger entity, you tend to have more negotiating power with insurers," he said, also citing the formation of accountable-care organizations. The groups are networks that receive government bonuses for improving care and reducing costs.
"To be able to coordinate and manage their care to keep costs down, you definitely want to be a larger group," Auerbach said.
The trend presses doctors in smaller and solo private practices against a wall.
Choice Health Care is neither an officially formed medical group nor a health care system. It is an affiliation of private-practice doctors who share the same worries.
"It's a group where we exchange ideas on how to best provide community care without becoming extinct," said Dr. Vishva Dev, a Thousand Oaks cardiologist.
It also is a shield against corporate and institutional influence on patient care, doctors say.
"We want to be able to practice medicine the way we always have," said Dr. Harris Wasser, a Simi Valley endocrinologist.
Several doctors said their primary concern is the UCLA expansion. The system opened a primary-care office in Westlake Village two years ago and now runs three more clinics in and around the county. Facilities in Simi Valley and Calabasas are in the offing.
"By expanding into the Ventura County area, UCLA Health System is able to provide our patients with better access to primary and specialty care experts associated with its renowned medical centers, research programs, nationally ranked medical school and residency training programs," spokeswoman Simi Singer said.
The pitch frustrates Simoni and others. He said much of the care in local UCLA centers is being provided by physicians who joined the network system, selling their private practices for compensation and other perks.
"Overnight you become a professor," he said.
Asked about the claim, Singer responded with a written statement saying many of the doctors in UCLA's area clinics were trained in the university system.
"Perhaps the bigger issue to consider is the fact that there is a looming doctor shortage on the horizon," she said. "According to the Association for American Medical Colleges, its data projects a shortage of 90,000 doctors in the U.S. by 2020." Private-practice doctors said they needed to unite to deal with the brand name and marketing power of UCLA and others. They said they named their new group carefully. They want people to know they have choices.
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