Independent medical clinics face a more difficult time keeping oncologists on board because of declining drug revenue and the higher salaries earned by oncologists.
That dilemma faced Corvallis Clinic, a multi-specialty group, which lost Dr. Maury Blitner, its only oncologist, earlier this month. He had been at the clinic for two years.
“It came down to economies of scale,” said Brad Wakefield, who’s been the clinic’s CEO since 2015. “Reimbursement is barely keeping up with the cost of drugs. In the good old days, we made a lot of money on drugs, but that’s no longer the case.”
Hospitals such as Samaritan Health Services, which recently opened a $10 million cancer center across the street from Corvallis Clinic, fare much better because they qualify for lower drug prices under the federal 340B program. Several years ago the only oncologists in Corvallis worked at the clinic.
“I would have loved to have kept oncology services if we could have,” Wakefield said, “But, in the long run, when we looked at it, this was a service we couldn’t afford to provide. I love hospitals but when they don’t have to pay property taxes and get a better price on drugs, the playing field isn’t very level.”
Wakefield’s held meetings with Samaritan to prepare the transition so that its cancer patients have the information needed to receive needed services.
The most recent Medscape report showed the salaries of oncologists increased by $27,000 in 2016, reaching an average of $329,000, ranking them as the ninth highest earners, with orthopedists and cardiologists at the top of the pay scale.
Despite the loss of Dr. Blitner, who moved to Washington, the Corvallis Clinic remains strong, Wakefield said, with 80 physicians and 30 physician assistants and nurse practitioners on board.
“Our physicians definitely value being independent and being in an organization where they get to vote for the board of directors and have a lot to say about how to run their practice,” Wakefield added. “It’s an environment where they enjoy practicing medicine.”
Large practices such as Compass Oncology, which has offices in the Portland area and Eugene don’t face similar problems. Known as US Oncology nationwide with 1,400 practitioners, they are owned by McKesson, the largest specialty drug distributor in the country, Wakefield said. And despite the lower reimbursement for oncology drugs, these clinics provide radiation oncology which hasn’t been as hurt financially by the Centers for Medicare & Medicaid Services.
“They still make decent money on radiation oncology,” said Wakefield who was uncertain why CMS cut oncology drug costs. “That’s the mystery of CMS and how they do things. Sometimes they make a lot of sense, and sometimes they don’t. I’m sure there’s a good reason but I don’t know why.”
Diane can be reached at [email protected].
