MEDICAL GROUP EXPANDS TO MEET PRIMARY-CARE NEED

The largest medical group in Cape Girardeau is expanding in an effort to improve local access to primary-care physicians.

Internal Medicine Group is adding two local doctors to its staff in the next several weeks, and moving three pediatricians into the former Community Counseling Center at 24 S. Mount Auburn Road, the group's administrator, Bill Port, said Monday.

The expansion will increase the group's number of doctors from 14 to 16 by January. It's expected to increase to at least 17 by next summer, and ultimately could grow even more, Port said.

The majority of its doctors and staff will continue to operate out of the Internal Medicine building at 14 Doctors' Park.

Internal Medicine is leasing the former counseling center, Port said. The building is owned by St. Francis Medical Center, which recently remodeled the structure.

The two doctors joining the staff are Dr. Michael Wulfers, a family practitioner, and Dr. James Hoffman, a pediatrician. Both have been in solo practice in Cape Girardeau.

Wulfers is joining the Internal Medicine Group on Dec. 13, the same day that Internal Medicine will move some of its pediatric services into the leased facility on Mount Auburn Road. Hoffman is scheduled to join the practice on Jan. 2.

Port said pediatricians Jean Diemer and Gary Olson will move from the Doctors' Park location to the Pediatric Annex on Mount Auburn Road. Hoffman will also be located at that facility.

A fourth doctor will be added to the Pediatric Annex group next July and the Internal Medicine Group is continuing to look at recruiting more physicians, Port said.

There's an acute need for primary-care doctors in the Cape Girardeau area, he said. "In the last year or so, a number of doctors closed up their practices here in town. They either retired or went to work in (hospital) emergency rooms or left town."

Port said area residents were having trouble finding primary-care doctors. "The public was getting very distressed."

In response, Internal Medicine began looking to expand its physician staff. Olson was hired about three months ago.

Port said the group considered expanding its Doctors' Park facility or moving part of its operations into a second building in the medical park, but neither option proved feasible.

"Our group has gone into this whole venture very enthusiastically," observed Port. "We sort of assumed this is a community responsibility, if you will, to try to do something to provide health-care services and expand health-care services in town."

The remodeled Mount Auburn Road facility has 21 examining rooms and space to accommodate up to seven physicians, said Port.

"It's laid out well. They can get from exam room to exam room, with a nursing station right there," he noted. "In effect, there are two waiting rooms. They can seat probably 50 to 60 people at a time."

"By leasing the old Community Counseling Center," said Port, "we'll be able to provide convenient and accessible pediatric care while at the same time providing the most efficient and convenient services to our other patients through our Doctors' Park location."

Doctors Sarah Aydt and John Russell will continue to see pediatric patients at the Doctors' Park facility because they are not only pediatricians but internists as well, said Port.

"About half of their practice is adults," he explained. Since many adult patients need lab and X-ray services, which are available at the Internal Medicine building in Doctors' Park, the decision was made not to relocate Aydt and Russell, said Port.

Wulfers will be establishing a family medicine department at the Doctors' Park facility.

Both Port and Wulfers said future plans call for adding additional family practitioners to the group.

"It's conceivable that down the road we could move Dr. Wulfers and another family practitioner over there (to the Mount Auburn facility)," said Port.

Wulfers said Monday that he's looking forward to joining the Internal Medicine Group. "I think it gives me an opportunity to, hopefully, form a group family practice.

"Certainly, I think everyone knows the community needs more primary-care physicians," said Wulfers. "I think it will be a lot easier for me to recruit someone in the group setting."

Wulfers said it's difficult to be a solo practitioner these days because of all the paperwork required. "Quite honestly, I would predict in five years there will be no more solo practitioners."

Wulfers concedes he has some mixed feelings about the move. "You give up some independence, but there are a lot of advantages for me and the patients, too."

With the group, Wulfers said, he won't have to spend as much time on administrative and business duties as he has had to do with a solo practice. As a result, Wulfers said he'll have more time to actually practice medicine.

"They (solo practitioners) are sort of a dying breed," said Port. "It is nothing that has happened to them through any fault of their own."

But he explained, "You have got to be big enough to be heavily computerized and have some resident experts on processing Medicare and Medicaid."

Said Port, "There are certain efficiencies you are able to obtain just because of sheer size."

The Internal Medicine Group currently has 54 non-physician staff members.

Having a large medical staff has advantages other than administrative. It's easier for doctors to rotate being on call, and they can consult with their fellow physicians in the group on particular medical cases when the need arises, said Port.

"Not everybody who gets sick is easily diagnosed," he observed. "Not everybody follows the cookbook medicine that Hillary Clinton would like us to."

Port said a large medical group also allows a person to receive a variety of care. Internal Medicine has everything from pediatricians to internists, as well as cardiologists, an infectious disease specialist, an oncologist and a rheumatologist.

"That's what we are shooting for, to be able to provide a setting where we practice very good medicine in that we cover as many bases as possible," he said.