Saturday, May 21, 2011

Ophthalmology practice focuses on growth, education

Almost 30 years ago, three retina specialist firms in the Washington, D.C., metropolitan region decided to joined forces. Today, the Retina Group of Washington is the largest retinal disease treatment practice in the country, according to a national trade group, with 20 physicians in 11 locations.
With headquarters in Greenbelt, the Retina Group combines specialists, research and education in a practice that treats more than 33,000 patients annually and employs more than 100 people, according to company information. Within the past three years, revenues have grown 24 percent as the company added locations in Bowie, Silver Spring and Fredericksburg, Va. The practice did not disclose specific revenue figures.
"We've gone from being a mom-and-pop shop to a small and now a medium business," said Reginald J. Sanders, a certified ophthalmologist who was the fourth physician to join the practice.
Further company growth will depend on opportunity, although the practice is considering more Maryland locations and expansion outside its target area, Sanders said.
Its plans could be affected by the major changes in the nation's health care landscape. The industry is facing a 30 percent cut in Medicare reimbursements, which physicians are lobbying Congress to repeal, said Kevin Walter, spokesman for the American Academy of Ophthalmology.
The industry also is likely to face more demand for its services, especially in treating age-related conditions, with the Medicare population expected to double with the upcoming retirement of baby boomers, he said.
"Now the gauntlet thrown down is the new health care system," Sanders said. "We have no idea what shape that will take, but we're paying attention to the best of our ability so we can adapt. Our large market share will help with that."
The practice is looking at more than growth, however, he said.
"Our mission statement has evolved over the years," Sanders said. "Right now, it's to become the leader in this area in the latest and best quality retinal macular physicians, cutting-edge research and technology and most advanced clinical practices."
The practice focuses on problems that occur in the back of the eye, such as macular degeneration, which can cause blindness in its wet stage and typically affects the older population. More than 2 million Americans 50 or older have an advanced stage of the condition, according to the American Academy of Ophthalmology, with about 10 million Americans having some stage of the disease. The Retina Group also is the only area practice to offer patients a detection device to diagnose the onset of wet macular degeneration, according to the company. This was made possible through the practice's ongoing research and clinical trials with both the National Eye Institute of the National Institutes of Health and private industry. Efforts to contact the institute for comment were unsuccessful.
"The practice may be involved with between five to 10 active clinical trials at any given time," said Richard Garfinkel, a medical adviser for macular degeneration and one of the group's practitioners at its Chevy Chase office. He joined 23 years ago when the group's three original firms still were around. A. Raymond Pilkerton was the last of the original group to retire in the past few years.
Aside from its size, the Retina Group stands out for the diversity among its practitioners, which was an accidental result of its effort to recruit high-quality physicians, said Sanders, who was the first black physician to join a U.S. retina practice. There are only several hundred black ophthalmologists in the nation, according to the academy, which on its website actively courts blacks to join the profession.
The practice includes pediatric specialists, diabetic specialists, trauma specialists, macular degeneration specialists and an ocular oncologist. Having so many specialists in one practice, so patients need go from practice to practice, is one of the group's advantages, Sanders said.
"If they run short-staffed, they will have people come from other locations to fill in, so patients are always well taken care of," said Phyllis Marshall, a Bowie patient who was recently diagnosed with wet macular degeneration in both eyes. "I would never go anywhere else."
Marshall said the physicians, particularly Sanders with his positive and upbeat manner, help give her confidence about her treatment. She has been a patient with the practice for six years.
In pursuing its second mission of education, the group conducts a fellowship program through Georgetown University/Washington Hospital Center, where the Retina Group has trained ophthalmologists for 10 years. The group also works indirectly with the hospital center in providing care for uninsured patients, according to both the Retina Group and the hospital.
Sanders said the original group never intended to become as large as it has. In fact, six years ago, when the group had 12 physicians, the founders would say they planned to grow no more. It just happened, he said.
"Once you get a core of really good doctors, it's not hard to attract others," he said.
The practice, though not a limited liability partnership, works as a democracy, Sanders said, with each physician having one vote on issues such as expansion and locations. It also provides economies of scale, so employees can share expenses and resources.
"Part of the nice thing about being in a large practice is if you see a patient with a complicated problem, you have the option of second and third opinions," said Daniel Berinstein, one of the pediatric physicians at the group's Chevy Chase location. He added that the equally large patient population in this region has led to many treatment breakthroughs from the group's research.

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