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Split from Asante likely for doctors Trust board exploring options By DAVID PRESZLER An uncertain future awaits the 39 doctors and 246 support-staff employees in the Southern Oregon Health Trust. Faced with increasing financial pressures, Trust doctors will likely separate themselves and their staffs from Asante Health System, perhaps by late this year, officials said Friday. "The environment is constantly changing and we need to change with it," said Dr. Bill Husum, the Trust board's chairman. Just what changes will be made -- and how they will affect the doctors and their staffs -- remains to be decided. The Trust has not been dissolved but the board has voted to explore its options. Patient care and services will not be affected by the changes, Asante and Trust officials said. "It should be totally transparent for the patients," said Roy Vinyard, Asante's president and chief executive. The pending shakeup, which Trust and Asante officials say is amicable, comes nearly seven years after the doctors and their staffs agreed to become Asante employees. Asante is the nonprofit corporation that owns Rogue Valley Medical Center in Medford, Three Rivers Hospital in Grants Pass and Hearthstone nursing home. The majority of doctors who work in Asante hospitals are in private practice. The Trust doctors, largely primary care providers, became Asante employees as a way to deal with competition from health maintenance organizations and to help recruit high-quality doctors to the area, Husum said. When the Trust was formed in 1993, HMOs and large hospital groups were paying primary care doctors higher wages, attracting much of the top talent. By aligning itself with Asante, the Trust, he said, succeeded in bringing good new doctors to the area. In recent years, though, salaries have become more uniform and changes in health-care finances have been significant enough that the Trust relationship no longer makes as much sense as it once did, Husum and Vinyard said. While no decisions have been made, Husum says the most likely scenario would be for all or the majority of the doctors to form an independent clinic. "There is a majority core of the Trust that envision they will be working together," said Husum. Such a clinic would give the doctors greater autonomy and more flexibility to navigate what Husum and Vinyard expect to be turbulent financial waters. "We're facing some very difficult times ahead," said Husum. The amount that Medicare and insurance companies reimburse hospitals and doctors has been reduced in recent years, while costs have continued to climb. Husum says separating from a large entity like Asante might make it easier for doctors to react to further changes and deal with reduced reimbursements. "The hard reality is that primary care physicans operate on a small margin," said Husum. "They have to be very innovative. "We're not naive enough to think this is going to be easy." The changes could hurt the 246 nurses and other employees, Husum admitted. "I wish I could say there weren't going to be changes," he said, adding that staff members are crucial to the continuity doctors want to present to their patients. "We intend to work as hard as we can to maintain that continuity but the reality is out there and I don't think I can make any promises." The changes won't affect Asante's construction of two new clinics in Medford, on Stewart Avenue and on Barnett Road. Today's Business Index Mail Tribune Copyright � The Mail Tribune 1999, Medford, Oregon USA