Reliance on high-tech and high-turnover leading to lawsuits in ‘hospitalist’-heavy San Antonio

In health-care speak, patient encounters are used to tally revenue that doctors bring into practices. The industry average is about $75 per encounter, according to trade magazines. I figured IPC earned about $97 per encounter this year. I was unable to verify the estimate since neither public relations contacts, nor the investor relations official, or the local IPC director returned calls seeking comment. My estimates are on 3.5 million encounters and $340 million in revenue the company reported in the first three quarters of 2011. With average salaries of $260,000 in 2008, IPC doctors were among the highest paid hospitalists. About 40 percent of that pay was tied to incentives linked to patient encounters.

The company’s executives are well-regarded in the medical community. In October, the Medical Group Management Association and the American College of Medical Practice Executives named Dr. David Bowman, executive director of IPC’s Tucson, Ariz., office, as “Physician Executive of the Year” for 2011. Dr. Singer, IPC’s CEO, won the same award in 2010. Bowman also received special kudos for triaging U.S. Rep. Gabrielle Giffords and six victims shot by a gunman in a Tucson parking lot in January.

The stock price has doubled since 2008, when it raised $148 million in its initial public offering. IPC’s decision to go public during the recession turned out to be a clever strategy. Health care stocks, which typically perform well during recession, were up nearly 15 percent this year, leading the S&P’s 10 sectors.

For tech-loving venture capitalists and NASDAQ traders, IPC and its software offer an ingenious business model that corporatizes the patient-doctor relationship with a payout pipeline from Medicare and private insurance to Wall Street. With no apparent major capital expenses or debt, IPC appears to be pulling in cash faster than a strip club in a South Texas oil town on payday.

Critics say such corporate models reduce hospital care to a sales leader board found in a used car dealership, where the volume of sales matters more than quality of care. “Any program based predominately on volume, without paying due attention to quality, is not going to be as good a model for patients,” said Dr. Maynard, of the Society of Hospital Medicine. “I’m not going to say that is IPC’s model. I don’t know enough about that company to say if that’s a fault.”

A European study published in 2010 linked iatrogenic events to 19.5 percent of patients admitted to an intensive care unit (ICU). Old age, multiple doctors, and mixing medications were listed among risk factors. De La Zerda’s family thinks that’s the recipe that landed the former Chandler Assisted Living resident in the ICU at Metropolitan Methodist.

On February 16, De La Zerda complained of congestion and frequent urination. As a precaution, the family asked an ambulance to transport her to the ER room at Metropolitan Methodist. An ER doctor told the family she appeared healthy, but the hospital wanted to observe her in a telemetry room for 24 hours.

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