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PSYCHIATRIST QUITS PRIVATE PRACTICE TO JOIN

WALLA WALLA VA -- High costs and poor

reimbursement spur move

to government sector.

 

 

Story here... http://www.union-bulletin.com/
articles/2007/02/04/local_news/local1.txt

Story below:

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Johnson not happy about difficulties tied to private psychiatric practice

The doctor is closing his business, leaving the general public with only one psychiatrist.

By Sheila Hagar

How Dr. Rob Johnson feels about his psychiatric practice may be best indicated by how he views his surroundings.

Inset wood-panel walls reflect the warm glow of artistic lamps. A tabletop fountain tinkles soothingly while fat pillar candles flicker. Exuberant wall and table art saves the upholstered furniture and coordinating area rug from being too formal.

"I love this place," he said with a smile, his gaze resting on a display cabinet containing a multitude of souvenirs and knickknacks and looking somewhat set apart from the decorating style of the room. "Those are all things my patients have given me."

This particular sanctuary, down the hall from the reception area in the Eastgate office, will exist for only a short time longer. Johnson, 55, is leaving private practice by mid-March, he said.

That brings the general population back to having just one psychiatrist, Dr. Daniel Varnell at Blue Mountain Medical Group.

It also means a loss for Walla Walla County's Department of Human Services. Johnson has been treating about 270 people through the agency, said Sharon Saffer, executive director.

The county is making transition plans for clients and is striving to find another psychiatrist as soon as possible, she added.
The debit in private and county mental-health provision will be a gain for the Jonathan M. Wainwright Memorial Veterans Affairs Medical Center. Johnson has been offered a full-time staff position, which will fill a vacancy open for quite some time, said VA spokesperson Roxanne Sisemore.

Johnson's hire will raise mental-health staff numbers there closer to ideal, she said. "We're excited to get it filled."

It's not a simple choice to leave the office and patients he loves, Johnson said.

But work hasn't been simple for some time.

"When you go and hang out a shingle, despite having great billing and oversight help, the overhead is so expensive and reimbursement so poor, that makes it inviable," he said. "It's been years of barely squeaking even."

There is no lack of folks in Walla Walla who want and need his services, the physician said. "This was a `banner year,' my accountant told me."

But a psychiatrist going solo - with no agency to help absorb the costs of malpractice insurance, infrastructure, rent and staff - will soon be a thing of the past, Johnson believes.

Continuing education, for example, becomes a costly mandate for a practitioner who can't see patients while undergoing required yearly training.

Too, it's a difficult field in which to be isolated from peers. He misses the colleague contact at conferences and seminars, he said. "It means so much to go somewhere, sitting with others and talking over ideas."

Such conversations allow doctors to determine if they are providing an appropriate standard of care and do other self-checks, Johnson added.

Going solo wasn't the original prescription for professional happiness. Johnson and his family arrived here in 1992, recruited by St. Mary Medical Center to practice in its inpatient treatment facility for mental illness.

When the unit closed in 2001, he spent some time trying to blend a community mental-health service agency with a hands-on practice, which was difficult to do, Johnson remembered.

Other than having to run it as a business, private practice has provided him with a large measure of satisfaction, he said. Clients - he sees about 30 a week - have had "great continuity."

He, in turn, has been allowed to share their lives in "the deepest way possible," the doctor said. "They've told me things they probably didn't tell another human."

Yet being one's own boss is an illusion, Johnson has found. Doctors answer to insurance companies and federal regulations, both guilty of increasing demands on his time, he said.

"The practice is the boss. There are so many rules you have to follow...even Bill Gates has to sleep under his desk sometimes."

He has had multiple offers to go to larger cities, Johnson said. Walla Walla is home, though, and the VA job comes tied with a ribbon of promise of a new facility, now in the proposal phase.

"It will be a great opportunity to provide state-of-the-art mental-health care," he said.

As more veterans return from Iraq, this VA hospital can expect to see war-related mental-health issues on a larger scale, he said.

In addition, the new job gives him a chance to practice his speciality in a purer form, not as a business owner with an eye on overhead.

It's nice, as well, to plan family time and to invest in his own retirement, Johnson said, with a laugh. "I'd like to be able to quit one day and still be able to eat."

No benefit package erases the loss he feels in saying goodbye to his present patients, the doctor added, glancing again at the memento cabinet. "They are my people, they really are."

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Larry Scott  --