91.1 F
San Fernando
Thursday, Mar 28, 2024

Dr. Adam D. Singer

At a time of enormous change and uncertainty for the health care industry, the San Fernando Valley region is home to many who are embracing the challenges boldly with new ideas and fresh vision. The 10 innovators profiled in the following pages are emblematic of the important work performed by health care workers every day. They are working to improve care and lower costs — and answer the urgent need for a better health care system. In 1991, when it first occurred to Dr. Adam D. Singer that having a hospitalist coordinate the care of patients in the hospital was a good idea, the term hospitalist did not even exist. Today, there are 30,000 practicing hospitalists across the country who deliver and coordinate the care of acutely ill patients in the hospital. Dr. Singer’s company, North Hollywood-based IPC The Hospitalist Company Inc., launched with venture capital 16 years ago. It now is the leading hospitalist company in the country with revenues expected to reach $450 million this year, an increase of 17 percent from 2010. Apart from identifying a new niche in health care, Dr. Singer, chairman and CEO, has developed new standards for how patients are cared for in a hospital. His focus: making health care more efficient, reducing patient days in the hospital, and improving the overall experience for patients. Doctors who refer patients to the hospital have traditionally supervised and coordinated the care of those patients. But these days, as Dr. Singer likes to point out, more than 100 people touch a patient during a typical four-day stay. Referring physicians may check on that patient briefly in the morning, but the rest of the day, there is no one to supervise what those 100 people do. “Doctors have no ability to come into the hospital any more,” said Dr. Singer. “We stepped into that void.” IPC hires hospitalists and provides them with the benefits of private practice and fewer headaches. For example, IPC provides services such as billing, collections, recruiting and training. The company has also invested tens of millions in an IT system that allows the company’s 2,000 physicians to communicate virtually, consult each other for advice and work collaboratively. Since these doctors have no office other than the hospital where they work, the virtual office keeps them grounded and connected. Hospitals get the services of IPC hospitalists virtually for free. IPC bills the patient’s insurance. Dr. Singer says the potential benefit to insurance companies is more coordinated, better and less expensive care, since patients go home sooner and are less likely to be readmitted when a hospitalist is in charge. He estimates that by cutting readmission rates 40 percent — from about 20 percent to 8 to 10 percent — his firm saved insurers $160 million a year on the 750,000 senior citizens who were supervised by an IPC hospitalist. Now Dr. Singer has moved IPC into the post-acute care environment, such as rehab centers and skilled nursing facilities. Uncoordinated or flat-out poor medical care in some facilities has meant that almost as soon as patients are out of the acute care hospital, many are sent right back. “The way things are done in a skilled nursing home, the doctor would show up once in a while,” Dr. Singer said. “In the meantime, if someone had a fever, the patient was sent right back to the ER. Guess what that does to costs?” So starting about a year ago, IPC expanded aggressively into post-acute care facilities. It is now in 500 such places nationwide; the service accounts for almost 16 percent IPC’s total business, Dr. Singer said. Now that the health care industry is seeing the benefits of hospitalists, Dr. Singer says his biggest challenge is finding enough qualified professionals to meet the demand. It’s not that physicians don’t like the idea of being on salary, he said. It’s more that many coming out of private practice are not accustomed to the enormous challenges of coordinating complex care for a patient in crisis. “It’s a totally different relationship with the patient,” he said. “It’s short term, high impact versus long term, low impact.” This year, IPC together with the University of California, San Francisco (UCSF) launched a one-year fellowship to train hospitalists for this kind of intense care. The first class of 37 completed its training last month. “There’s been no such thing as a hospitalist training program like there has been in fields like cardiology,” Dr. Singer said. “We have in many ways built an entirely new specialty.”

Featured Articles

Related Articles