ER doctor group plans clinic in Woodbury

[Minneapolis/St. Paul Business Journal, January 22, 2010] (subscription required) - by Chris Newmarker Staff writer

Emergency Physicians, which provides doctors to hospital emergency rooms around the Twin Cities, plans to open a facility like no other in the area — a stand-alone clinic that can treat roughly 80 percent of typical emergency cases.

The Minnetonka-based practice is in negotiations with Robert Muir Co. to lease about 9,000 square feet, and construct an additional 2,200 square feet, at one of the shopping centers Robert Muir owns near the junction of Interstate 494 and Valley Creek Road in Woodbury.

Emergency Physicians, or EPPA, plans to spend an initial $1 million, drawn from operational funds and financing, to open the facility. Emergency Physicians is still deciding on a general contractor.

Brent Wilde, EPPA’s executive vice president and chief operating officer, said the goal is to see patients by June.

The facility wouldn’t take ambulances, but would have the emergency-room doctors and equipment needed to treat many of the conditions that bring people to ERs, including chest pains, kidney stone attacks and severe asthma. The most serious cases, such as acute strokes, would be transported to area hospitals.

The EPPA clinic would directly compete against the emergency department at HealthEast Care System’s Woodwinds Health Campus, a hospital less than two miles away from the proposed location. Bob Gill, HealthEast’s chief financial officer, was surprised to hear that Emergency Physicians is creating the facility.

EPPA — which has about 130 doctors working in six hospital emergency rooms on the west side of the Twin Cities — sought to get its doctors into Woodwinds’ ER. HealthEast recently decided not to bring in EPPA.

EPPA’s move into the area isn’t a “viable addition to the Woodbury community,” Gill said, adding that there are actual emergency rooms nearby at Woodwinds and other HealthEast hospitals such as St. John’s in Maplewood and St. Joseph’s in St. Paul.

Wilde acknowledged that Emergency Physicians wouldn’t be moving into Woodbury if it had reached a deal with HealthEast. But it still would have opened the facility elsewhere in the Twin Cities, he said. EPPA has been planning the facility for the past three years.

“We’re going to do this thing,” Wilde said. “It wasn’t a bargaining chip.”

Striking out on their own

Dr. Gary Gosewisch, EPPA’s CEO and president, said the practice’s goal is to run an emergency operation on its own, free of hospital bureaucracy. The doctors believe it will prove popular with patients because it will provide many of the same services as an emergency room, but with more efficient care and reduced wait times.

Because it won’t be attached to a hospital, the doctors will be able to charge less to the patients and their insurers. Emergency Physicians is seeking agreements with the major insurers in the state, including Blue Cross and Blue Shield of Minnesota, HealthPartners and Medica, to make sure the facility costs patients less out of pocket than a hospital emergency room.

“They need the expertise of the physician to make the right diagnosis and make the right treatment plan, but it doesn’t have to be done at a hospital,” Gosewisch said. “We believe that we can provide the same level of expertise and the same level of care as could be provided for 80 percent of the patients coming into an ER.”

The Woodbury facility will initially be open 12 hours a day, seven days a week, and have at least one emergency physician present at any given time. It also will be staffed by 20 to 25 nurses, physician assistants and lab technicians, and have capabilities such as CT scans, ultrasounds and a diagnostic lab.

The center will be a cross between a hospital emergency department, which is licensed by the state to accept ambulances, and an urgent-care clinic, which is staffed by family-practice doctors, physician assistants and nurses who see patients without an appointment.

The focus won’t be the routine medical problems seen at an urgent care, but even in those cases, Gosewisch thinks his doctors have an advantage, because their ER training enables them to spot serious and rare conditions.

“We’re going to take the well-trained docs and put them in a different building with all of their tools, equipment, staff — all the things that allow them to do their job — as if they were in the hospital.”

Doing something different

Emergency Physicians’ plan is unique for the Twin Cities area, said Joseph White, a health care principal at Larson Allen’s Minneapolis office. It will fill a void in the marketplace, the need for emergency medicine at a lower cost.

The Woodbury clinic will add some competition to the Woodbury area — and hopefully get the area hospitals to innovate more, too, White said. “In theory, more competition is good.”

Minneapolis health care analyst Allan Baumgarten noted that some hospital systems in other parts of the country, such as Texas, have built stand-alone emergency rooms as a way to test the waters in new markets. But what EPPA was doing was news to him — a case of “entrepreneurial physicians” who see a business opportunity for a different type of model, one that would give them better control of revenue and patients.

“You think they would try to start out in some part of the metro area that doesn’t have an emergency department. But maybe they think the population can support growth.”

Emergency Physicians
CEO and President: Dr. Gary Gosewisch
Headquarters: Minnetonka
Description: Emergency-physicians practice

Work in six hospital ERs: Allina Hospitals & Clinics’  Buffalo Hospital in Buffalo, Mercy Hospital in Coon Rapids and Unity Hospital in Fridley; Fairview Health Services’ Fairview Southdale Hospital in Edina and Fairview Ridges Hospital in Burnsville; and Park Nicollet Health Services’ Methodist Hospital in St. Louis Park.

Employees: About 130 doctors and about 50 additional office staff
Revenue: Not disclosed

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