The move mirrors a national trend among doctors who are increasingly trading in their own private practices for the security of working for a hospital institution.
“It is becoming increasingly difficult for a small, privately-owned practice like ours to stay competitive and provide the quality we are known for,” said Dr. Penny O’Neill, a partner with Sylva Pediatrics.
O’Neill said she and the other doctors had to choose which hospital to affiliate with — Mission in Asheville or MedWest-Harris in their own backyard. Mission made more sense for several reasons, O’Neill said.
For starters, they are a “first-class outfit,” O’Neill said.
“That is where we refer our patients for all specialty care,” O’Neill said.
Harris will remain their first choice for routine hospital care, but for highly specialized needs — like pediatric surgery, children’s cancer treatment or neonatal ICU — the Sylva Pediatrics group has always referred to Mission.
“So, we had a working relationship with them anyway,” O’Neill said.
Mission also brings a host of resources to the table, from business management to clinical expertise.
“The management of running a practice, it seems like that is becoming ever more complicated,” said Dr. Susan Mims, vice president and medical director of Mission Children’s Hospital. “Being part of a hospital system helps preserve physicians’ ability to spend time with patients and they don’t have to be concerned with that other part of it.”
Sylva Pediatrics will be the first group of physicians in Jackson County to seek out a partnership with Mission over their local hospital.
On some level, the decision reflects dissatisfaction among the Jackson medical community with Harris’ management structure. As part of the MedWest trio, Harris is stuck in a partnership with Haywood as well as a management contract with Carolinas HealthCare that it no longer wants to be in.
Jackson County doctors have publicly endorsed the idea of partnering with Mission instead. So it’s no wonder Sylva Pediatrics went the route that it did.
“There is a lot of turmoil. We love our hospital and would like our hospital to thrive, but we have not been happy with the Carolinas affiliation,” O’Neill said. “What I have heard over and over is we want to regain the culture of our hospital. It has always been a medical oasis. We would really like this to become a first-class community hospital again.”
While Mission has been accused of using aggressive methods in neighboring counties — from vigorously competing for patients to trying to woo physician practices — that is not in fact the case, O’Neill said.
Sylva Pediatrics Associates approached Mission about taking over their practice, not the other way around, O’Neill said.
“We actually invited them. They did not come to us,” O’Neill said.
And Mission has assured the practice that it wants to provide care as close to home for patients as possible — not siphon them away to Asheville.
“Part of their mission is to support the practices in the community in their referral region so they can remain there to care for patients,” O’Neill said.
O’Neill said her practice doesn’t feel any pressure or obligation to send children to Mission now.
In fact, it’s a win-win for Harris. The hospital won’t lose the loyalty of their pediatric team, and likewise didn’t have to make the investment to buy the practice or put the physicians on its payroll.
The Sylva pediatricians will be the first primary care doctors under Mission Children’s Hospital. It is far more common for specialists, such as pediatric endocrinologists or neurologists, to be employed by the hospital.
“For subspecialists it is very hard to make it on your own, so the hospital is invested in supporting those physicians to make sure there is access for the people of Western North Carolina,” said Dr. Mims.
But even primary care doctors, particularly in comparatively rural areas, are giving up on the private practice model these days.