An Organizational Analysis Of Heartcare Midwest, S.C.

HeartCare Midwest is central Illinois' largest cardiology practice consisting of nineteen physicians and more than two hundred nurses, medical technicians, and administrative staff in more than twelve counties throughout the state. Founded in 1994, HeartCare Midwest is the product of a corporate merger between the well-established practices of Cardiovascular Medicine and Illinois Heart Institute. Having more than two hundred years of experience between them, HeartCare Midwest physicians' hold medical and advanced cardiology degrees from such impressive universities as Duke, Harvard, Princeton and the University of California at Los Angles.

HeartCare Midwest's affiliations with major medical centers in the area like Saint Francis, Methodist, Proctor and Pekin make the new cardiology practice strategically positioned for growth in the medical industry. HeartCare employs some of the most highly educated and experienced cardiac nurses in the area, allowing the practice to be licensed and certified for specialized techniques usually only available from medical facilities in large metropolitan areas. This analysis will include an extensive evaluation of HeartCare Midwest's goals and objectives before and after the merger. In addition, structure and strategy, its organizational system, and HeartCare's effectiveness after the merger will be examined in detail. Additionally, I will make recommendations on how HeartCare Midwest could improve their organization.

Goal's and Objectives

Before the merger creating HeartCare Midwest, Cardiovascular Medicine, consisting of thirteen physicians, held close affiliations with Saint Francis Medical Center. In its beginnings, the physicians defining Cardiovascular Medicine were once part of a multi-specialty health care organization, owned by Saint Francis Medical Center, consisting of nephrology, internal medicine and cardiology. Maintaining a close relationship with Saint Francis Medical Center, the cardiologists left the medical center-owned group in 1983 to form the area's first independent cardiovascular specialty group. Cardiovascular Medicine was founded on the belief that advancements in cardiovascular studies would enrich the quality of life and increase life expectancy. To that end, the physicians dedicated their new practice to the collection of crucial cardiovascular data for use by world wide medical studies for the prevention of heart disease sponsored by Duke University.

In 1986, Anthony Brody, a British research cardiologist, joined Proctor Hospital to direct their new Chest Pain Center and Proctor's new cardiology departments. Soon after, Dr. Brody recruited five other research cardiologists from around the world to join him in his pursuit. Illinois Heart Institute was born one year later. Similar to Cardiovascular Medicine, Illinois Heart Institute's physicians had a mission to improve the quality of life and abolish heart disease. However, they chose a different path to accomplish the same goals. Instead of research being the main focus, Illinois Heart Institute's mission was realized through innovative public education programs, physician seminars showing revolutionary medical procedures using nuclear technology, and by taking an active role with charity organizations like the American Red Cross and the United Way.

Understandably, HeartCare Midwest is a complementary mixture of both practices' visions with some new goals. The physicians maintain a strong dedication toward research, education and medical advancements; however, they have their sites set on new goals driven primarily by future economic outlooks and market demands for better, cost-effective health care. A multi-specialty organization is again what the market demands. Although the new multi-specialty group will be associated with many medical organizations in a five-state radius, no hospital or medical organization will directly own it, making this the only the third multi-specialty group in the state not directly under the control of a leading medical center.

The new multi-specialty group will offer several specialty fields including internal medicine, gastroenterology, surgical, oncology, neurology and cardiology services. The fundamental ideas behind making such a radical change from a single entity practice to a multiple entity practice is simple. Market forces are driving health care prices drastically down and profit from treatments and services alone are no longer adequate for survival. In addition, insurance companies are beginning to dictate where their customers receive health care and also the price a provider is paid for services rendered. Most insurance providers are beginning to look for health care organizations strategically positioned to offer medical services at reasonable prices, diversified medical services under one roof, and demonstrate strong alignments with leading medical centers in the area. As a result, HeartCare Midwest must undergo a facelift to survive changes in the health care industry.

Competitive Environment

HeartCare Midwest's competitive environment is significantly reduced over a non-specialized practice. Cardiology, in comparison to internal medicine or gastroenterology, is in a far better position to shield itself from direct competition. Statistically speaking, one out of 500 people who become physicians will choose the field of cardiology. The field of internal medicine, however, has an inflow of physicians at a rate of one in 10. The American Medical Association (AMA) attributes this to the six additional years of education required to be a cardiologist and the stringent entrance requirements of medical schools offering the cardiology program.

Although direct competition from individual cardiology practices in the area is no real threat, the presence of multi-specialty groups, like what HeartCare's is planning to become, in large metropolitan areas continues to draw patients from rural-type communities like Peoria to their larger clinics. Beyond that, insurance companies will often look at a metropolitan-based community over a rural town purely on the assumption the larger community has better resources. In addition to location, insurance companies also look at where care is administered. Despite the rumors, physicians are not the ones making all the money. When a procedure is performed, charges are generated for both HeartCare and the medical facility where the procedure was completed. Unfortunately, the insurance companies treat both the charges from the medical facility and those from HeartCare as one