ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, February 20, 1996 TAG: 9602200052
SECTION: BUSINESS PAGE: B6 EDITION: METRO
SOURCE: SANDRA BROWN KELLY STAFF WRITER
Four doctors employed by Carilion Health System and five in private practice have been hired as part-time medical directors to help design and monitor patient care for the Roanoke-based health care company.
Their selection was announced Monday.
The doctors will continue their patient practices, as the company required in selecting them.
Carilion, which owns or manages 14 hospitals, reorganized itself last fall based on services it offers instead of facilities it operates. The plan is intended to provide a consistent quality and level of services throughout the territory Carilion serves. The company also wanted to be more efficient and cut costs.
Medical services were divided into 10 specialty areas, or service lines, such as cardiology, oncology and primary care and women's services. Physician volunteers were then brought into the process to help design procedures to assure consistency.
One of them, Dr. Randall Falls, is the new medical director for women's services.
Falls, who practices in the Community Ob-Gyn Inc. group, headed a team that standardized physician orders for post-operative care related to a Caesarean section, a surgical delivery of a baby. The plan had nothing to do with when a C-section is done, but it eliminated unnecessary lab tests, Falls said.
He said the experience developing those guidelines piqued his interest in applying for the medical director role.
"I see a real transition occurring in health care, and I know that a lot of physicians are afraid of it," Falls said. "I can't say I'm not a little scared myself, but I see it as a way to have some input into changes instead of waiting for them to sweep me over.
"There is some self-interest. But I see a real need for doctors to be fiscally responsible; there has been a lot of waste in the system in the past."
Falls has just completed a two-year stint as chief of the ob-gyn department at Community Hospital of Roanoke Valley, a Carilion facility. That was a volunteer position.
His new paid duty, which began Feb. 1, will take about 10 hours a week, he said. His first tasks will be to help develop a mission statement and establish ways to measure procedures' effectiveness.
The amount of time the medical directors must commit will depend on how many changes need to be made, but will vary from five hours to 20 hours a week, said Dorman Fawley, executive vice president for patient care services.
No matter what the time commitment is, though, Fawley said placing physicians in leadership positions with the hospital system is a "landmark" decision.
"It puts teeth in the concepts of teamwork and collaboration, the platitudes we talk about," he said.
Medical directors who are not already Carilion employees, in addition to Falls, are Dr. Paul Frantz, cardiology; Dr. Robert Keeley, medical/surgical services; Dr. Jack Hutcheson Jr., oncology; and Dr. William Mirenda Jr., orthopedic.
Frantz is with Cardiovascular Surgical Associates Inc.; Keeley with Physicians Care of Virginia; Hutcherson with Oncology and Hematology Associates of Southwest Virginia Inc.; and Mirenda with Roanoke Orthopaedic Center.
Carilion physicians named to the posts are Dr. Donald Kees, assistant director of pediatric medical education, pediatric; Dr. Richard Surrusco, medical director of emergency services for Roanoke Memorial and Community hospitals, primary care; Dr. Daniel Harrington, director of psychiatric education, psychiatric; and Dr. Bruce Stelmack, director of rehabilitative medicine, subacute services.
A director for community-based services, which includes home health care, has not been selected. Fawley said he is still educating physicians on the expectations for that position and doesn't have a pool of applicants.
That director will probably have to spend the most hours in the job, Fawley said, because Carilion's home health involves several independent companies that need to be transformed into a regional service.
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