In 1991, when Adam Singer answered an ad for a physician to take care of hospitalized patients, he never imagined that he was on the cusp of an emerging industry.
Fresh out of a fellowship program in pulmonology, he was just looking for a way into the profession. "I just wanted to make hay for my practice," Singer said.
What Singer ended up with was an entirely new business, a medical practice that specializes in the care of acutely ill patients. North Hollywood-based IPC The Hospitalist Co., one of a still-small group of practices in the so-called "hospitalist" field, provides physicians who oversee patient care from the time of admission in a hospital through discharge. These doctors handle all facets of the stay, from ordering tests to writing treatment plans and supervising follow-up nursing care or other services needed when the patients return home.
Since the company was founded in 1995, it has grown at a blistering pace; from $3.5 million in 1997, it grew to $10 million in revenues by 1999 and this year, company officials are projecting revenues of $45 million. It now operates about 30 hospitalist practices in five states California, Arizona, Missouri, Illinois, Texas and Colorado and openings in another six markets are planned for next year.
"Over the next three years, we will be across the country and we will be fairly well-saturated (nationally) in five years," said Singer, who is president and chief executive of the company.
IPC's doctors may substitute for a primary-care physician during the patient's hospital stay, or they may be assigned to patients who have no primary-care doctor. The company is paid for its services by the patient's insurer or by a referring agency, such as the hospital itself or a skilled nursing care facility where the patient resides.
The field emerged during the 1990s as managed care cut the time and conditions allowed for hospital stays, sending more patients to the doctor's office for treatment. With their waiting rooms full, doctors had less time to attend to those patients who did require hospital care. Many also found that the expertise they needed for treating acutely ill patients was markedly different from the skills required to handle a typical office visit.
The National Association of Inpatient Physicians, a professional group for hospitalists, estimates that there are more than 5,000 such practitioners nationally, but most are small, local operations.
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