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Doctor groups compete at MWH
Mary Washington Hospital is in the unusual position of having competing hospitalist groups in the building

Date published: 8/26/2010

BY JIM HALL

Mary Washington Hospital recently ended its contract with the Fredericks-burg Hospitalist Group and signed instead with another company, HMG, to provide hospitalist services.

Yet some doctors with Fredericksburg Hospitalist Group chose to stay and compete with HMG rather than depart the hospital.

As a result, Mary Washington is in the unusual position of having competing hospitalist groups in the building, one the "official" group under contract, and the other independent.

Both groups have courted community doctors, hoping to care for their patients. And the hospital recently asked doctors to choose one or the other.

"I decided to go with the new group," said Dr. Timothy Powell, founder of the Fredericksburg Christian Health Center.

Powell said he chose HMG since many of his patients are uninsured, and HMG doctors care for the uninsured.

"I wasn't unhappy with old group," Powell added. "I certainly have a number of friends there."

For two hospitalist groups to compete within a hospital is rare but not unheard of, said Joseph Miller, senior vice president for the Society of Hospital Medicine, the professional society for hospitalists.

Usually there is only one hospitalist service in a hospital, Miller said, since the service often gets a subsidy from the hospital to care for the uninsured.

HMG receives such a stipend from Mary Washington. Fredericksburg Hospitalist does not, though both companies are also able to bill patients' insurance companies.

"It's going to be a tough road but not undoable for the old group to survive," Miller said.

So far, it's hard to tell which group is more popular. Dr. Javed Akram, medical director for HMG, said Monday that his group had responsibility for 102 patients that day.

Officials of Fredericksburg Hospitalist did not return phone calls seeking comment.

Mary Washington officials declined to say how many patients each group has been caring for.

"After the first week, HMG became the physician group managing the largest number of patients in our hospital. Their patient census continues to grow," hospital officials said in a statement.

So far, the competition does not seem to have affected patients.

Akram said this week that the two groups have worked well together.

"Our relationship and interaction so far with them has been very collegial," he said.


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Hospitalists are the doctors who work in the hospital. They're there 24/7 to admit patients, check on them while they're sick and prepare them to return home.

Often hospitalists have agreements with local primary care doctors to care for their patients while the patients are hospitalized.

The hospitalists report to the primary care doctors when the patients are discharged, and the patients return to their doctors for continuing care.

HMG, based in Ohio, is a national hospitalist company that works in 50 hospitals in 18 states, including Potomac Hospital in Woodbridge.

The company began caring for patients at Mary Washington Hospital on July 29. It has 18 doctors there to provide around-the-clock coverage. Eight doctors are on duty at any time, said Dr. Javed Akram, medical director.