More than 20 years before the term hospitalist was coined, the Brockie Medical Group, a strong internal medicine practice led by Benjamin Hoover, MD, relished its hospital work at York Hospital in York, Pa. Back then, the doctors didn’t call themselves hospitalists, but the time they spent on hospital duties made them the forebears of today’s hospitalists.
According to John McConville, MD, chairman of York Hospital’s department of medicine and a hospital fixture since 1976, some of Brockie Internal Medicine group’s physicians devoted 60% to 70% of their practice time to inpatient tasks. “That was the culture when I arrived on the scene,” he recounts. Shortly thereafter, the group grew stronger when The Brockie Internal Medicine Group’s main competition—a sizable family practice group—fell apart. Brockie absorbed its like-minded physicians.
The Brockie Internal Medical Group is firmly anchored in York, Pa., home to factories that produce barbells and Harley-Davidson motorcycles. York has a soft side, though—it produced the first Peppermint Pattie, a mint-chocolate candy. It is an affordable, rapidly growing suburb, a place where commuters to Philadelphia, Baltimore, and Washington, D.C., can have a comfortable lifestyle without big city housing prices and the hassles of urban life.
The medical community is close-knit, described by Jonathan Whitney, MD, a Brockie hospitalist leader, as “a collegial environment with a growing population and plenty of patients, so there’s not a sense of competition among physicians.” Dr. Whitney, along with William “Tex” Landis, MD, and Michael Lamanteer, MD, form the Brockie Hospitalist Group’s executive committee, elected decision makers who deal with WellSpan Health and York Hospital on behalf of their colleagues.
As York grew, so did the Brockie Internal Medical Group. Then came managed care in the 1980s and 1990s, and Brockie’s internists were not happy. “We saw the medical landscape changing everywhere, and we didn’t want managed care pushing us around,” explains Dr. Landis, a Lancaster, Pa., native and now the Brockie Hospitalist Group’s lead physician. “Analyzing how medicine was changing, we felt vulnerable as a single specialty group. We considered various scenarios for becoming a multi-specialty practice, but decided that wasn’t right for us.”
So, in 1995, five group partners decided to sell the practice to WellSpan Health, an integrated nonprofit healthcare system located in South Central Pennsylvania. Their expectation? That WellSpan’s administrative support and financial muscle would protect them against managed care’s encroachment.
Affiliating with WellSpan Health aligned Brockie with the medical services line of York Hospital, providing the administrative support they needed to grow and thrive. Working together, Brockie’s medical leaders and WellSpan administrators oversee the following areas: strategic planning; budgeting, compensation, benefits, and incentives; collections and coding; care management and performance improvement; recruiting and other personnel issues; and scheduling and coverage.
The Hospitalist Program
York Hospital and its surrounding community continued to grow, as did the need for more office-based and inpatient physician services. By 2001, York Hospital’s top executives recognized that a dedicated hospitalist group was the best solution for its overflowing emergency department (ED), booming admissions, and climbing average daily census. As specialists in internal medicine already heavily involved in inpatient care, the Brockie Internal Medical Group was York Hospital’s obvious choice to pioneer a hospital medicine program. Five Brockie physicians chose to join the newly minted inpatient hospital group (the Brockie Hospitalist Group), with four others continuing outpatient care. Over time, seven more hospitalists came on board, with more anticipated in late 2006 through mid-2007.