Two new medical ventures in Greater Cincinnati and several regional “boutique” hospital projects are challenging the traditional ways Tristate hospitals have provided services.

Techician Betty Marshall demonstrated a digital mammography scanner at Proscan Women's Imaging. (Gary Landers photo) | ZOOM |

        For the past eight months, growing numbers of women have been turning to Proscan Women's Imaging in Madisonville,

        a for-profit service where women can get fast answers about whether they have breast cancer - and do it in more comfort than in many hospitals.

        Meanwhile, starting Tuesday, patients will be able to use the $11 million UC Physicians medical office and imaging center in Butler County's West Chester Township. The University Pointe project is the first step in a $100 million plan to serve one of the region's fastest growing areas by building a hospital-like medical campus, one piece at a time.

        “This is an exercise in re-engineering the health-care system,” said John Gillespie, director of marketing and development for UC Physicians. “But we're trying to do it in a way that doesn't hurt the existing system.”

        While different in terms of scale, both projects share a common thread - they are trying to take advantage of changing medical technology to reach patients who have become ever more frustrated with the services provided by budget-pinched local hospitals.

        Proscan Women's Imaging exists in large part because radiologist Dr. Hugh Hawkins grew weary of trying to improve mammography services as director of breast imaging at the University of Cincinnati's Barrett Cancer Center.

        As part of the much larger UC Medical Center, Dr. Hawkins found his requests for better equipment, more inviting dicor and faster service standing in line with dozens of other budget priorities. It was easier to make the changes by going independent.

        “We're trying to address the priorities of the patient, not the system,” Dr. Hawkins said. “I had my idea of what a perfect breast center would be. But over the last eight to 10 years, a lot has gone on in the health care system here. I got frustrated.”

        At many hospitals, women often wait three to five weeks between the discovery of a suspicious lump and confirmation of whether they have breast cancer, and even longer to actually get treatment. That time has been reduced to a few days, sometimes the very same day, for many patients at Proscan.

        Women who come in for diagnostic mammograms do not leave the office without talking to a radiologist about the results of their scan. If the image is clear, the good news is shared right away.

        If there are potential signs of cancer, a doctor breaks the news in person and the office staff offers to help schedule the next steps, including biopsies and consultations with surgeons and oncologists. Proscan also can perform two kinds of biopsy procedures at its Red Bank Expressway office.

        Laurie Acklen, a 48-year-old resident of Indian Hill, said she was surprised by the same-day results, especially after waiting weeks for results from other mammography services. Proscan also performed a follow-up biopsy on the next business day and provided results of that procedure within 24 hours. Good news: no cancer.

        “You go in, take the test and you sit for a few minutes while Dr. Hawkins reads it. Then he sits down with you and talks about what he saw. The whole thing was so pleasant and comfortable,” Mrs. Acklen said.

        In its fastest example, last month, Proscan helped arrange a whirlwind of testing and care for a woman whose doctor felt a suspicious lump in her breast. She got a diagnostic mammogram, a biopsy, surgery and the beginning of follow-up treatment in nine days.

        For many women with breast cancer, the time from diagnosis to treatment ranges from six weeks to 16 weeks or more, Dr. Hawkins said.

        Such speedy treatment is possible in part because the center is co-owned by several physicians, including breast cancer surgeon Dr. Donna Stahl and her partners, who share an office next door to the Proscan center.

        Some women - depending on their insurance, physician arrangements and their own willingness to seek treatment - aren't able to move so quickly. Insurers' willingness to cover services at Proscan have been mixed, Dr. Hawkins said. Even so, the patient walks away with a clear picture of what they're facing, Dr. Hawkins said.

        Meanwhile, in Butler County, the very definition of a hospital is being challenged by the emerging University Pointe medical campus.

        This project is a direct response to suburban growth increasing demand for nearby access to high-skill medical specialists, and high-tech diagnostic services and treatment.

        On Tuesday, an 80,000-square-foot office opens its doors to patients. It features offices for 25 doctors, ranging from neurologists to dermatologists, and an imaging center offering MRI, CT, mammography and bone density scans.

        Within weeks, developers plan to break ground on a linear accelerator, dialysis center and day spa that could be open in spring 2003. Within a few more weeks, developers expect to know when construction would start on an ambulatory surgery hospital.

        “Is this the hospital of the future? In some ways it is,” Mr. Gillespie said.

        Improved medical technology has made it possible for most surgeries to be performed without a hospital admission. Many doctor groups can buy imaging equipment that rivals hospital-based machines. And with digital imaging making it possible for patients to be in one place and doctors somewhere else, there's less need than ever to drive to the big city hospital to get medical care.

        But unlike some for-profit ventures that can take business away from non-profit hospitals, several key parts of the University Pointe campus are part of a joint venture with the Health Alliance of Greater Cincinnati. The alliance includes the Christ, University, Jewish, St. Luke and Fort Hamilton hospitals.

        “If you take the profitable things out of the hospital system, and leave the hospitals stuck with all the money losers, you just put the hospital system in a more precarious situation. We didn't want to do that here,” Mr. Gillespie said.

        But hospital administrators here are well aware of the “category-killers” looming on the horizon. Elsewhere in Ohio and Kentucky, traditional full-service hospitals already feel pressure from emerging single-specialty hospitals, often called boutique hospitals.

        Within 100 miles of Cincinnati, one heart hospital already has opened in Dayton. Another heart hospital is planned in Columbus. Meanwhile, medical centers in Louisville are planning to launch a cancer hospital.

        No free-standing specialty hospitals have opened in Cincinnati, although Christ Hospital is building a $77 million cardiac care wing that would amount to being a heart hospital. There also has been talk in recent months of neurosurgeons with the Mayfield Clinic joining with other spine specialists and orthopedists to build a spine hospital. But that project remains in such early stages that it is still unclear if it will be built.

        “We're probably 30 to 60 days away from a final decision,” said Mayfield spokesman Tom Rosenberger.

        Members of the Ohio Hospital Association already have complained to state lawmakers that boutique hospitals threaten to erode the financial health of more traditional community hospitals. But specialty hospital developers say they are simply responding to health-care market forces.

        In Cincinnati, where doctors have decried a local shortage of specialists, the new out-of-town hospitals could draw patients away from the city - especially those who already live in distant suburbs. But how much of a threat specialty hospitals pose depends on how traditional hospitals respond.

        “People shouldn't be leaving Cincinnati for health care, and in my opinion, they don't need to,” Mr. Gillespie said. “It's true that cherry-picking annoys the industry. But it's supposed to be about what's best for the patient.”

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