When Goliath corporations dominate a market, how can the Davids fight back? This Barrington-area physicians group is betting on a strategic alignment with like-minded players.
Increased complexity and consolidation in the health care industry are dramatically impacting the way smaller, independent practitioners do business. In order to respond to pressure from government regulation, gargantuan corporate interests and goliath competitors, locally owned practices are being forced to fundamentally change their business models in order to survive.
This dog-eat-dog marketplace has encouraged some creative thinking at Lake Cook Orthopedic Associates (LCOA), in Barrington.
“Larger and larger corporations are making more of the decisions, for all of us – doctors and patients alike,” says Dr. Gregory Brebach, principal and spine surgeon. “As a nine-member partnership orthopedic practice, we’ve developed our own reputation here, but we feel like it’s harder for us to practice medicine as we’d like. A lot of contracts are being dictated to smaller companies. We don’t have the ability to negotiate these contracts like we think we should.”
Soon, Brebach and his partner physicians will be able to focus more time and attention on their patients, trusting the tricky business side to experienced experts. Late this summer, LCOA announced it was merging with Illinois Bone & Joint Institute (IBJI), a collective of physicians scattered around northwest Chicago, North Shore suburbs and northwestern suburbs, including Arlington Heights.
IBJI is a physician-owned practice that’s served the Chicago area since 1990 and currently specializes in every orthopedic specialty. The deal with LCOA is its 10th such merger. Once completed, the deal will join together more than 100 physicians at 22 locations.
The merger is expected to help LCOA to continue delivering its high-quality health care at an affordable price, says Brebach. From a patient’s perspective, little should change.
“The whole point of doing this is to secure some managerial excellence that will help us negotiate these contracts and help us expand to areas we haven’t been before,” says Brebach. “That will help us to deal with increasingly complex government regulations regarding things like human resources and even Medicare.”
Operating as a “division of” the Illinois Bone & Joint Institute, LCOA will continue to operate with a degree of autonomy, something Brebach says was essential in preparing the practice for the future, and something he didn’t see from other potential suitors.
“We still want to run the business like we see fit,” he says. “This current arrangement, as it’s written, will allow us to do that.”
One quality that’s distinguished LCOA since it was founded in the early 1980s is its hometown approach to quality medicine. Founder Dr. Frederick Locher started the practice at a time when agriculture was prevalent in Barrington and traumatic injuries, related to farming, were commonplace. But as the community has evolved, so has the practice’s expertise.
“If I have one mentor in the medical world, it’s Fred,” says Brebach, who joined the practice in 2003. “He taught me how to carry on what he created, because I succeeded him about four or five years ago. What we’re trying to build upon is the same thought process of taking care of the patient first, and taking care of your employees first.”
The independent group of nine physicians specializes in orthopedic surgery and rehabilitation in areas such as sports medicine, diagnostic imaging, physical therapy, joint replacement, and treatment of injuries to the shoulders, elbows, wrists, hands, joints and spines. These physicians bring experiences in prestigious locales like Northwestern University, Vanderbilt University, Rush University, Loyola University and Cleveland Clinic. In addition to diagnostic tools such as X-ray and MRI, the practice maintains a staff of physical therapists who work at the Canlan Sportsplex, in Lake Barrington.
Maintaining its hometown approach to medicine, LCOA also remains tightly knit with the Barrington community. Six physicians live in town. Several, like Brebach, grew up here. The remaining physicians live nearby, in places like Hawthorn Woods and Deer Park. Each gives back to their hometown in some way.
“We volunteer around the area,” says Brebach. “We’re team doctors for the Barrington Broncos football team, and we’re doctors for the Lake Zurich Bears football team. I volunteer as a coach for my son’s baseball team, and I love it. We try to be as involved as we can in the community, donating as much of our time and money as we can to local charities.”
Recently, LCOA donated 4 acres of conservation land surrounding its main office on Illinois Route 22. The property straddling Flint Creek is home to a variety of wildlife and numerous young oak trees. The nonprofit Citizens for Conservation will maintain the land as part of its nearly 150-acre Flint Creek Savanna preserve.
Through the new relationship with IBJI, Brebach looks forward to diving deeper into the community and finding new ways to serve the region. In particular, he’s looking for opportunities to better serve patients who live in McHenry County. By some time in 2017, he expects to open a new location in the eastern part of the county.
“We’d love to be part of that community more than we are right now,” he says. “We’re looking forward to it, and I think we’re going to provide the best possible care for economically feasible fees.”
Closer to its home base, LCOA is upgrading technology and adding a new MRI machine that promises improved diagnostics. The physical therapy room at the Sportsplex is also getting an upgrade, with a new rehab room expected to open late this year.
“We’re also hoping to expand our services into an urgent care clinic and other things that will allow us to see patients at more-convenient hours,” says Brebach. “There are many things the merger will allow us to do, on the market side, to re-employ our resources. This merger allows us to do many impressive things on the back office side of the business, in areas like HR.”
Brebach is focused on retaining a competitive edge at LCOA, and wresting market share from his much-larger competitors.
“You’ve got to be smarter about how you do things, or else you’re going to succumb,” he says. “Either you’re going to get bought out against your will, or you’re going to retire, and we don’t want to do either. A lot of doctors’ practices are allowing themselves to be bought out because they’re tired of swimming upstream.”
Brebach emphasizes that the merger shouldn’t affect the patient experience. He looks forward to investing more time with patients, doing the work that first led him into practice.
“We want to be the best physicians we can be, so we want to make an organizational change that will allow us to do that, and I think this merger effectively does that very well for us,” Brebach says. “It allows us to practice medicine as we should. This is a physician-owned entity and allows us to be more nimble, and address the concerns that physicians have regarding patient care.”