PLEASE NOTE: The interview below was done July 11, 2011 by Becker’s ACS Review

John Bookmyer is CEO of Pain Management Group, a management company in Findlay, Ohio, that operates joint ventures in pain management with seven hospital partners.

Q: What sort of relationship do you have with hospitals?

John Bookmyer: We work closely with partnering hospitals to organize and maximize their facilities, resources and services to provide comprehensive, hospital-based, multi-disciplinary pain treatment centers. We are convinced a hospital can run a very efficient and effective pain center that allows physicians to maximize their fees and offset any expense incurred by the hospital.

Q: Why do your centers focus exclusively on pain management?

JB: Pain management does not work well with other types of specialty services. It does not have similar processes to other specialties. Our focus on pain allows us to be extremely efficient in managing volume, either in the clinic or phone calls, and identify the right employee for the right task and the right physician.

Q: How does a hospital benefit from having a pain center?

JB: These centers engender high patient satisfaction and they provide support for primary care physicians, who get many chronic pain patients. Unused space in the hospital can be transformed into a profitable enterprise. Our systematic approach and processes can reduce operating overhead to as little as 30 percent. The centers also help increase brand awareness of the hospital in the community. We aggressively obtain competitive pricing from vendors and work with hospital partners to expand and capture a larger share of the outpatient market. In 2010, our pain program at Blanchard Valley Health System recorded 19,327 patient encounters, up 29 percent from 2008.

Q: What sort of planning does this entail?

JB: Before the center opens its doors to the community, we work with hospital marketing staff to develop and execute a marketing and advertising plan to promote the center to internal stakeholders, referral sources and the surrounding community.

Q: How does the pain center interact with physicians on staff at the hospital?

JB: For this arrangement to work, the primary care physician has to be willing to let the pain physician follow the patient. Most primary care physicians allow this because they no longer want to manage pain themselves. PMG keeps the referring physician informed about care.

Our pain specialists follow the patient as soon as a pain diagnosis is identified. This allows the pain physician to perform an initial work-up and order labs and imaging. By having a long-term relationship with patients we can gain efficiency.

Q: How do you standardize the clinical process?

JB: In fluoroscopy, for example, we try to standardize the view over and over again. The physician says, “This is the procedure I’m doing and this is what I am going to want to see from my C-arm tech.” The procedure varies only when the doctor sees a need for it. In another example, physicians work out a standardized methodology to anesthetize the patient. They identify the specific amount of anesthesia, depending on the procedure.

Our hope would be that our physicians could be interchangeable. After physicians are hired, they go through a process to gradually bring them over to our process. Our medical director, Ned Lakshmipathy, MD, spends a lot of time with new physicians in their first year to align the organization and physician. That investment pays off. In addition to 100 percent hospital partner retention, we also have 100 percent physician retention. The goal is, “Let’s learn from them as much as they learn from us.”