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(Continued from page 72)
Second tier clinics will be in neuro-oncology.
BUSINESS STRUCTURE
The individual clinics may continue to be "independent businesses" employed by the hospital. There will be a single 1-800 phone number, a single physician neuroscientist administrator, a single medical record number which will be the hospital number, a single billing number and single clinical coordinator. The business plan must be developed before obtaining physicians. It will be politically, economically and more expeditious to fit the physicians into the PLAN then to fit the plan to the physicians. The clinics will all be housed in the hospital complex [65,000 sq.ft]. The clinic physicians may be employed by the hospital "in private practice" which is less advantageous or remain in independent private practice. Billing, basic support staff and clerical staff will be through the hospital system.[70@0.20 A] Upon collections the hospital will take 4%, plus the actual cost of hospital staff, rent and supplies. The remainder of the collections will go to the physicians account in total. Therefore all clinics will have to carry the same insurance. The NSC clinics will display both in their office and on their personnel the logo of the Neuroscience Center. Outside true private practice physicians can work at NSC. The patients are seen at NSC and remain the patients of NSC. Any referrals have to be to NSC staff physicians. These private practice physicians will use the healthcare and support staff of NSC for which they will be charged a monthly rent. The Neuroscience Center office will be located on the premise of hospital.
CLINIC CARE
Each individual clinic will be connected by an intricate computer system. Each clinic must except and send referrals between clinics. Clinical pathways will be developed for each disease with mandatory referrals to specialist. The clinical pathways will include mandatory therapies as well as mandatory tests. These pathways will be followed in the ER and by all hospital owned physician practices. When a patient contacts the clinic they will talk to the Clinical Coordinator who will obtain demographic information as well as the disease information for which they are seeking treatment. The Coordinator will then make the appropriate referral. The patient as well as the information will be entered into the computer system and sent to each individual clinic for review. If the individual clinics deem that this patient should be seen in their office, as well as the one that the patient is being referred to, then the additional referral will be necessary. The Clinical Coordinator is the position that binds the physicians, hospital, staff and is responsible for the continuum of care.
All patients admitted to the hospital onto the service of one of the individual clinics, will be seen daily by the Clinical Coordinator. (Continued on page 74)
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