Intervention accepted

The status of health care in America seems to be in constant flux these days. But over the past 16 years, since Dr. Roy Bishop opened Argyll Medical Group in Chico, much also has remained the same. In particular, private practices have continued to struggle in an industry ruled by government mandates and insurance company bureaucracies.

“Insurers refuse to pay reimbursements that are in line with our expenses,” Bishop said during a recent interview at his Philadelphia Square office. “So, if you’re a small physician group, insurers like Blue Cross and Blue Shield are paying us under Medicare [rates]. And we have no leverage to make them pay more. And if you’re part of a bigger corporation … they will pay more. It’s sad, really.”

Bishop originally imagined Argyll as a solution to the private-practice problem. While specialists have increasingly turned to hospitals to manage their practices, primary care providers don’t have that option in Chico—Enloe Medical Center does not take on primary care physicians. So, those doctors have had to rely on medical management groups such as Argyll, Mission Ranch Primary Care and Mangrove Medical Group to share resources and get better rates than an individual physician could.

Unfortunately, Bishop said, he’s no longer confident in that business model. So, starting Sept. 1, Argyll will be owned and managed by MyCircle Health, with Bishop staying on as medical director.

“The main thing is, and the reason for this change is, to be able to provide what the people in this town need,” he said. “We need more providers—more physicians, nurse practitioners and [physician assistants]—and it’s impossible to do that now with physician ownership. You need larger corporations with more capital, more technology and better contracts with the insurers.”

The change will come with other perks as well, Bishop said, pointing to MyCircle Health’s commitment to technology and integrating it into caring for chronic illnesses. That technology—which includes things such as Internet-connected smart watches, heart monitors and scales that track a patient’s day-to-day health—all will be available to Argyll patients moving forward. They’re meant to help predict when somebody’s going to get sick.

“There’s more technology to track your hamburger than there is to track your health,” said Lonny Davis, CEO and chief technology officer of MyCircle Health, which is headquartered in San Diego. “We’ve taken some very specific hardware and software, and we’re going to apply it to every person in the practice. We can use it to compare how their treatments are going and how their health is progressing.”

Davis offered an example of a patient who goes to the doctor with high blood pressure. As standard protocol, he said, that patient may be prescribed a medication whose side effects include development of a dry, hacking cough. “Many people may just think, ‘Oh, I just have allergies,’ and not go in to see their doctor for several months,” Davis said. “But we have technology that will ring your smart watch and ask a question: ‘Have you started coughing lately?’

“It’s preventative, and it’s planned health care. So, we can monitor you without you necessarily coming into the doctor.”

That’s part of MyCircle Health’s philosophy: “population health” vs. the more typical fee-for-service health care. In that way, patients’ overall health is managed through various technologies as a means to cut back on doctor visits while still providing a high level of care.

“Patients with diabetes often have problems with their feet,” Davis offered as another example. “So, if you have diabetes, the doctor might ask you to take a picture of your foot every day this week, or once a week for a month, because he’s concerned you’re developing an infection. That doesn’t cost anything, but it’s how we approach chronic care.”

Bishop pointed to the uniqueness of this approach: “Argyll will be the testbed for this technology,” he said. Davis concurred: “This is the first large-scale roll-out of this technology that we’ve been working on for the past 5 1/2 years.”

Davis said patients likely will not notice any immediate changes at Argyll, which will retain its name, through the transition. There typically will be no charge for receiving technological equipment—smart watches that link to things like heart monitors or scales—and the providers will remain the same. Over time, however, each patient will transfer to the MyCircle Health care program.

Bishop says that, going forward, he hopes that under the management of MyCircle Health, Argyll will be able to better expand to include more primary-care providers as well as specialists who deal with chronic illnesses—in areas such as endocrinology, rheumatology and neurology. For him personally, it offers the opportunity to return his focus to medicine rather than dealing with bureaucratic paperwork and negotiations.

“I can concentrate more on taking care of patients, and as medical director I will help guide the new owners in providing the services people need, so I can concentrate on that and not have to worry about running the business day to day,” Bishop said. “I think that’s an improvement.”