Doctors, hospitals are getting a jump on reform

WASHINGTON — WASHINGTON -- After 18 years as a family physician in Indianapolis, Dr. Bernard Emkes was sick of the paperwork, the insurance company hassles and the government red-tape imposed upon the modern practice of medicine.

"It was overwhelming," he said. "I spent 20 percent of my time doing something administrative -- not taking care of patients."


So Dr. Emkes, like thousands of doctors these days, sold his practice to nearby St. Vincent's hospital last March and went on salary. He is no longer an independent physician, but he is a happier man.

"I got out from under a tremendous amount of administrative headache," he explained. "I don't see any downside for me or for my patients."


Dr. Emkes is part of a movement that is transforming the American health care system even before President Clinton and Congress take a whack at it.

Hospitals are buying up doctors' practices and organizing them into integrated health networks -- precursors of the "Accountable Health Plans" that would provide medical services to most Americans under the Clinton reform proposal.

Jeff Goldsmith, a health care consultant in Bannockburn, Ill., said "a virtual land rush" is under way as hospitals, burdened with too many beds and too little revenue, seek to assure themselves of a steady supply of patients by hiring their doctors.

"Everyone is looking to the future," said Don Fisher, chief executive officer of the American Group Practice Association. "Only an entity that can deliver care from womb to tomb is going to be a winner."