George A. Sprecace M.D.,
J.D., F.A.C.P. and Allergy Associates of New
Letter to Tom Blum
May 10, 2011
Based upon a cursory
review of that e-mail regarding a
cooperative initiative between the Hospital and the private practice
the following are my initial thoughts…which you may consider presenting
- Such an initiative does not require an
intricate new structure, developed by a team of outsiders at much cost. We have all of the ingredients here already.
- Any such effort must take pains to avoid any
problems with the Stark Laws and with the Anti-Trust Laws, since the
Federal Government has long targeted the Health Care Professions for
special scrutiny…in order to prevent any effective professional efforts
to thwart either a Business or Government take-over of that economic
market. To succeed in avoiding that
danger, any local cooperative initiative must succeed in defining The
Market as the entire catchment area from Norwich and beyond to Westerly
and to the Connecticut River. In that way,
our efforts can be shown to represent less than 30% of the area of
- We already have the excellent Staff, both
within and without the Hospital. We have
decades of community good will. And we can
compete both in our area and regarding the tertiary centers of
Connecticut and beyond.
- What we have lost in recent years is a
perception that we professionals are united and cooperating fully for
the benefit of the community. What a
patient does not want is a fractured “team” when he is vulnerable; and
that is the perception now.
- Agree individually that any form of
capitation or “bundling” or ACO is unethical, not in keeping with our
fiduciary responsibilities to our patients, and a cynical attempt to
have physicians ration their patients’ care…a function only appropriate
for the public at large.
- Inform the community of the great
education, training and experience of the members of our staff, both
Hospital and private. Believe it or not,
the community has only a vague awareness of this.
- Demonstrate these capabilities by abundant
and regular out-reach programs for the public on all manner of medical
/ health issues, produced by the staff members themselves…and not just
by outside “experts”.
- Complete finally the integration of the
Hospitalist program with the greater health care community by tight
communication with outside physicians: before, during and after a
patient’s discharge…a cooperation obvious to the patient lying on his
or back in the hospital room.
- Declare and demonstrate the new
cooperation in tangible ways to the community in order to reverse the
current perception of division. That must
involve every physician in the community. The
elements of such cooperation are already available to be applied
widely, without triggering an allegation of a “combination or
- Use such cooperation to petition our
governments regarding ethical methods for reforming our Health Care
System, developed from within and not imposed ham-handedly and
ignorantly from without.
Sprecace, M.D., J.D.
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