Merger protects OB/GYN care
Doctors’ defect from Shore thwarted

By Deborah Gates
Staff Writer

SALISBURY — Last week’s buyout of Eastern Shore Obstetrics & Gynecology by Three Lower Counties Community Services erases medical bills by several hundred dollars for Medicare patients and more than a half-million dollars for their physicians at the Phillip Morris Drive private practice that merged, effective Jan. 1, with the government-tied TLCCS, a top-ranking TLCCS official said last week.

Services, care and patient loads won’t drop, though, as the team of six OB/GYN doctors, support personnel and their patients join the community health center serving Somerset, Wicomico and Worcester counties, said Joan Robbins, executive director for TLCCS.

TLCCS is one of 1,000 community health centers in the United States recognized as a Federally Qualified Health Center, or FQHC, a designation that means the federal government pays physician premiums for medical malpractice insurance, Robbins said.

For doctors at the Eastern Shore practice, it equals a $520,000 premium waiver for 2007, said Dr. Daniel Eisemann, an obstetrician and gynecologist at the practice.

FQHC status, which locates health centers in medically underserved regions, means Medicare patients aren’t required to pay the annual $300 outpatient deductible that would be charged elsewhere, Robbins said.

The merger comes as medical malpractice insurance premiums skyrocket for physicians in general and obstetricians and gynecologists in particular, forcing some to decide to quit the specialty.

“Before we pay our staff, before we pay for health insurance, before we pay for new equipment, (a medical malpractice insurance premium) has to be taken care of,” Eisemann said. “And since we get paid less in reimbursements by insurance companies now, the money we needed to stay afloat was rapidly depleting.”

Robbins would not discuss terms of the buyout or salaries for the estimated 25 Eastern Shore OB/GYN physicians or staff members who as TLCCS employees continue to serve the same patients at the Phillip Morris Drive location.

“It is obvious to say the (acquisition) will be beneficial for everybody but mostly for patients,” Robbins said. “We are making sure patients get served.”

The acquisition brings to four the number of TLCCS community health locations throughout the Lower Shore. Other locations are in Princess Anne, the main campus, with dentistry, mental health, adult, pediatrics, obstetrics and gynecology medicine; and in Salisbury on Healthway Drive and in Pocomoke City, with similar services.

TLCCS last week also opened a pharmacy on the second floor of a new treatment center at the Princess Anne campus.

Robbins said an expected overall growth increase by at least 20,000 patient visits will not compromise patient care or volume at the Phillip Morris Drive location. In fact, leaving issues of medical malpractice premiums — and malpractice litigation — to the federal government, doctors can concentrate on patient care, similar to their counterparts in medical services for the military or veterans, she said.

In 2006, there were more than 80,000 TLCCS patient visits, a volume expected to top 100,000 this year, she said, attributing the increase to an influx of residents across the Lower Shore and expanded medical staff and services.

The projected increase is expected across the board and will not backlog services to obstetric or gynecology patients, she said.

Robbins also refutes a misconception that TLCCS, founded in 1994, serves only the poor or patients on a fixed income.

“This is not a free clinic; we take insurance, (but) if you make less than poverty, we base (fees) on an ability to pay,” she said, adding that TLCCS serves one in four Lower Shore residents in poverty.

Nikki Lavigne, a patient at the Phillip Morris Drive location more than two years, called the merger “a great option” for more patients.

“I have no problems with it,” Lavigne said. “I do not think my quality of care will be compromised.”

The marriage between Eastern Shore OB/GYN and TLCCS comes after a four-year courtship between the medical facilities. Since 2002, Robbins had paid the obstetricians and gynecologists to treat patients on rotation at TLCCS centers in Salisbury and Princess Anne, she said.

“They were working with me part time at two sites. The partnership went so well we decided to do the merger,” she said.