Englewood Hospital and Medical Center is seeking to help fill a perceived shortfall in primary care in New Jersey.
Dr. Stephen Brunnquell, president of MDPartners, a multispecialty network of physicians that is part of Englewood Hospital, said the network intends to add 25 to 30 primary care doctors in the next two years, as well as additional specialists and urgent care centers.
“I think primary care is finally being recognized as the most important part of the entire medical care system,” said Brunnquell, a family doctor by trade. “We’re the first provider that people see. We’re your family care doctor. So sometimes you come to us with colds and sprained ankles and things, and sometimes you come to us with weird symptoms and you don’t know where to start. Even if we can’t take care of you, we know the system and we will quarterback you through the system.
“So if you envision the system as a huge funnel, primary care is at the top of that funnel,” he added. “You need to have a robust primary care network that narrows down and feeds into your specialists and your surgeons. We as primary care doctors want to keep you out of the hospital. We’d like to intervene on your lifestyle choices and support you in being healthy.”
The network, launched in 2011, has 375 providers across 75 offices. Brunquell said it’s important the state add more family doctors, as New Jersey is already experiencing a shortage. But despite the state’s high property taxes, he believes the network can offer several enticements, including the EPIC electronic health records system, to lure them.
“Right now, the country has an average of 75 primary care docs per 100,000 people,” said Brunnquell. “In our area, we only have 65 family doctors per 100,000, so we’re already behind the national average, which, incidentally, is lower than what the average was 10 years ago. So we need to add probably 20 to 30 primary care doctors over the next two years just to meet our needs.”
Brunquell said EPIC was installed at Englewood Hospital in March and in almost all of its ambulatory centers. The system cuts down on medical errors and redundancies, and increases communication between all of its doctors. The system will also allow MDPartners to focus more on population health.
“When I talk to doctors about joining us, this is a huge selling point,” he said. “You’re now on one medical record, and we almost have all of the specialties, so you can be referred within our network. After that, then you can start to do population health. Now you have a group of people, and we’re pushing 100,000 patients, and we try to manage this group as a population and do things like care coordination in offices.
“So as we move from volume to value – which is where we’re going – this is the kind of infrastructure you need to have in place. If you’re going to take care of people and assume some of the risk that the insurance companies have had for years this is what you have to have. We’re well on our way.”
Brunquell said the system is also seeking to round out its group of specialists, and will seek to enter the urgent care market this year.
“We’ve started to add subspecialty surgeons to fill out what is truly a completely integrated medical group,” he said.
Brunquell added that the hospital system is close to adding ear, nose and throat and orthopedic specialists, and is in discussions with pediatricians.
He also said that the addition of the EPIC system paves the way to add urgent care.
“We almost have urgent care,” he said. “We’ve had discussions with an urgent care operator to do a joint venture, and we’ve also considered opening our own facilities. Actually, they’re not that hard or expensive to open, but the trick is getting the operating expertise much more than the brick-and-mortar.
“The urgent care centers would be part of our network. We know that 30 percent of people who go to urgent care do not have a primary care doctor. With urgent care, we will be able to feed those people into the primary care system that we’re enhancing. So now, you’re providing the convenience of the urgent care system but also providing a network that they can access with specialty care. It provides continuity that these people have never had.”
Despite the predicted shortage of family doctors, New Jersey does offer strong opportunities and has the advantage of being close to New York City and Philadelphia, Brunquell said.
“Our group is big enough so that our call responsibilities are very manageable,” he said. “And because of the demand for primary care doctors, the salaries are going up. So this is a great time for a young person to choose primary care. It’s a student’s market here.”
Brunquell said that the hospital has changed its criteria for residency applications in order to help keep primary doctors in New Jersey.
“We have our own medical residency here. For years, and not exclusively, our residents were primarily foreign born and foreign registered, and so they come here on a visa,” he said. “We changed the acceptance criteria a bit so it is a little easier for an American who may not have gone to school in this country for us to train them here.
“We’re sort of overhauling our own program to become a pipeline for our own primary care doctors. If we can audition five or six young doctors per year, then we’ll have our own farm system, our own minor leagues right here. We can sort of see if we like them to stay and well trained and see if we can convince them that primary care medicine is attractive.”