Physicians, hospital cooperate on center

More than 100 surgical specialty hospitals have cropped up across the United States in the last couple of years, and nearly all of them pit groups of physicians in bitter competition against a local hospital.

A new surgical specialty hospital in Carson City, however, is anything but competitive.

In fact, a physicians group and the Carson-Tahoe Hospital are partners in the facility.

Like facilities elsewhere, the $14 million surgical specialty hospital at the new Carson-Tahoe Regional Medical Center will fit a niche between day surgery centers where patients are in and out the same day and traditional hospitals.

It will handle relatively simple procedures, but patients may stay at the facility for several days after the procedure.

The 50,000-square-foot facility is scheduled for completion in March 2005.

It will include six operating rooms and 15 in-patient beds.

The new center, which hasn't yet been named, will be owned by the hospital.

The facility then will be leased to a venture jointly created by the hospital and a physicians group to operate the surgery center.

The partnership is rare, says Ed Epperson, chief executive officer of the hospital.

"As far we know, in almost every community it's a competitive situation," he says.

But Dr.

James Colgan, who helped spearhead the new surgical specialty hospital, says the hospital and physicians built on a longstanding relationship to create the new facility.

For nearly 20 years, a group of physicians originally 23, now 45 have operated a day surgical center in a cooperative venture with the hospital.

In fact, the Carson Ambulatory Surgery Center is located in the current hospital which is due to be replaced by the new regional medical center when it opens in late 2005.

Colgan has served as chairman of physician group since its creation.

Even as the board and executives of the nonprofit Carson-Tahoe Hospital were thinking through plans for the regional medical center, the physicians group recognized that it was outgrowing its quarters.

About 5,000 surgeries a year are completed at the day-surgery center.

The upshot? After studying surgical specialty hospitals elsewhere in the West and about a year's worth of negotiations, the hospital and the physicians decided to extend their partnership into the new facility.

Colgan gives much of the credit for the cooperative venture to hospital executives.

"In other places, the problem has been that the hospitals want to do it themselves," he says.

That pits the hospitals and their operating style against surgeons, who are primarily interested in efficiency so they can handle as many cases as possible through a day.

"Surgeons don't have much time," Colgan says.

The Carson City model in which the hospital provides the capital for the facility while the physicians provide the operational expertise promises to be ideal, he says.

The management of the Carson Ambulatory Surgery Center demonstrates the physician group's interest in efficiency, Colgan says.

The center is overseen by Joan Lapham, a registered nurse who understands the needs of physicians and patients alike from a medical background.

"I don't see many RNs running hospitals," Colgan says.

The surgical specialty will be in a freestanding building on the campus of the Carson-Tahoe Regional Medical Center taking shape at the northern edge of Carson City.

Its construction costs are financed by the hospital's own resources rather than a $95 million industrial development revenue bond which is financing the medical center itself.