Annals of Medicine
"Small practices are at a great disadvantage," said physician Ron Sanda.
by Jan Schlain
From the June, 2017 issue
Sanda should know: after thirty-three years as a solo practitioner, in January he gave it up to become one of nearly 500 doctors in St. Joe's giant multi-specialty practice, IHA.
Sanda came to Ann Arbor in 1981 from Chicago to do his residency at St. Joe's and stayed to open his own primary-care practice. More than thirty years ago, he rented an office at the back of St. Joe's urgent care center at Maple and Miller. "I wanted to practice the way I thought medicine should be practiced," he recalls in a phone interview. His patients parked steps away from his front door, where his small staff greeted them by name. With the urgent care center in the same building, "if an X-ray was needed, for example, they could walk over and have it done without having to get back into their car."
Joe O'Neal, founder of O'Neal Construction, has been Sanda's patient for more than twenty years. "I've been outliving my doctors," jokes O'Neal, eighty-four, "at least their practices." When he asked St. Joe's to recommend a doctor who understood runners, they recommended Sanda.
"I'm used to his mantra," O'Neal says by phone. "Eight glasses of water a day, fruits, vegetables. We may talk about Obamacare or a building I'm building, but he is very focused, very businesslike."
"I practice what I preach," says Sanda. "I'm a true believer in diet, exercise, stress management." He also believes in "providing all the basics" and thoughtful, personal service to a diverse group of patients ranging from lifelong townies to high flyers, literally--he does physicals for pilots. One former patient, auto exec and Road & Track columnist Bob Lutz, gave Sanda a ride in his jet. "He likes to go fast," Sanda says.
O'Neal especially appreciated that Sanda would regularly "open two or three phone lines to take calls from patients for free. He'd answer the phone himself," says O'Neal, amazed. "He'd say, 'I'll be with you in
a minute,' and he'd put you in queue until he had answered the call that came before."
But last year, Sanda's cozy world went topsy-turvy. St. Joe's closed the urgent care clinic when IHA opened its big new building on Jackson Rd., and Sanda needed to find another place to practice. Though he wasn't ready to retire, neither was he in a position to make a long-term investment in a new space.
O'Neal was the second-to-last patient Sanda saw at his solo practice and one of the first who followed Sanda to IHA's WestArbor Medical Center. He says the time they spent together felt the same, but the office experience didn't. "The new is all corporate," he says. "Lots of forms, which I never did fill out and never turned in."
Sanda had to learn a new record-keeping system, including "doing a lot of work on the computer before your patient even leaves the examining room." He doesn't like the fact that the people who schedule appointments not only don't know his patients by name, they don't have a clue about how much time they're likely to need. And he was "far more in control" in his private practice. "You could make decisions very rapidly. I could operate lean and mean," he says.
Though he keeps in touch with the staff from his private practice, only one, medical assistant Melanie Figueroa, came with him to IHA. On average, he sees about 320 patients a month. IHA would like him to see 400. "I tend to disagree with that number, but we'll see how that goes," he says. He's currently on salary, but after two years his income will depend on how many patients he sees.
The new center has far more extensive medical support services than the old walk-in clinic. On the healthy living side, Sanda texts, "They have nurses who do the Medicare wellness exams. When [they're] not overwhelmed, there are patient managers who can help patients get home care, help with finding resources to affordable medications, etc."
Sanda says some of his patients came to him from corporate practices, so "they were not happy I was joining a group." Some asked him for referrals to other private local practices, but he knew of none left to suggest.
For those who stayed and his new IHA patients, he vows, "I will not change how I try to treat my patients."
From Calls & Letters, July 2017"
"I read with great interest your article entitled 'Annals of Medicine' in the June 2017 issue of the Ann Arbor Observer," wrote Eric Straka, a physician with Partners in Internal Medicine. "In the penultimate paragraph, Dr. Sanda was asked to recommend other private local practices but 'he knew of none left to suggest.'
"I wanted to set the record straight and notify your readers that we have a thriving internal medicine practice with a total of 8 providers and a full-time staff of 30+ employees. We have an office in Ann Arbor and one in Canton that serve over 36,000 patients in Southeast Michigan."
[Originally published in June, 2017.]
On July 26, 2017, Debra Roberts wrote:
HVPA is an independent Physician Organization that supports 64 primary care physicians and close to 400 specialists. We can help direct patients to any open independent offices who provides high-quality personalized care. Please visit http:
/ /www.hvpa.com /physicians_directory_search.html
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