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Business and science

Barry McNamara
Dr. Diana Hearne ’82
“There are only three things to learn in skiing: how to put on your skis, how to slide downhill, and how to walk along the hospital corridor.”

With the motto “Like nothing on earth,” it’s no surprise that Vail, Colorado, is not only a vacation destination, but sometimes a stopping point, too.

Such was the case for Dr. Diana Hearne ’82, who moved to Vail more than 20 years ago to practice emergency medicine and ski for just one season as a break after residency training. She’s stayed there ever since, and is now a senior partner of Vail Valley Emergency Physicians P.C. (VVEP), an independent emergency medicine physicians’ group that contracts with two hospitals, staffing a level-three trauma center, three emergency ski area clinics, and two 365 day/year urgent-emergent care clinics over two counties.

Hearne said she isn’t “ripping the moguls up” like she did in earlier years, but she loves spending time with her husband and three children in the mountains. Her children clearly love the area, too, as is evidenced by a statement made by her then 6-year-old son.

On a trip to Hearne’s native Illinois, the child noticed the lack of mountainous terrain during the airplane’s approach to O’Hare International Airport.

“It’s really green and flat here, Mom,” he said. “I can’t see any beautiful mountains like we have at home. But it is probably a good place for bike riding.”

Skiing might not be as significant a part of Hearne’s life these days, but it definitely impacts her profession. She described her business as seasonal, with the majority of emergency department visits coming in the winter and spring ski seasons. The practice operates year-round and caters to a large tourist clientele including many international visitors as well as the year-round local population.

“This is not your average market for healthcare services, so we must understand cultural and logistical differences in a high altitude resort area.” Hearne said. “We work closely with the local hospitals and specialists, because many of our injured or sick visitors prefer to get surgery or procedures done while they are in the area rather than cut short a vacation. We can often expedite great care for patients locally that not only benefits the patient in timeliness and expertise but also has a business benefit to the hospital and other local specialty physicians.”

Asked what the future holds for physicians in private practice, Hearne replied, “This is a big unknown right now. It may be that business models like our own – small local private groups contracting services with the hospitals – are an endangered species. As such, it becomes even more important for us to push the unique advantages that we can provide to the community and to the hospitals.”

Hearne said the physicians in her group “need to go beyond providing good medical care – though that is always our foremost objective. We need to make sure we maintain our professional contracts to even have a job here. To do so, we need to quietly market ourselves continually with our hospitals and make sure we are providing the top-notch services they want so they, in turn, want to keep us at their ‘front door.’ We have unique talents and experience in this type of medicine. We need to keep that in a visible forefront to reinforce the benefits of contracting with our local group over hiring through a national or regional agency for what might be seen as cheaper physician coverage.”

She added, “Understanding the need for this business sense in a medical practice is outside of any teaching or training I ever received.”

The third-most senior partner and a member of the executive committee at VVEP, Hearne is involved in decisions with contract negotiations, personnel issues, human resources, staffing decisions and many other traditional small business issues. It wasn’t always that way. When she became a partner, she wasn’t as familiar with the business aspects of healthcare as were her senior partners. She preferred at that time to simply practice medicine and spend any free time with family, recreation and traveling. Now as the group’s president and founding partner has announced his planned retirement, Hearne is seeing the need to step up her involvement into even more of the business aspects of the group.

“I had no interest in learning about business while I was at Monmouth,” said Hearne, who admitted struggling through Financial Accounting at MC. “Spending more time on business courses could have helped prepare me more fully for the challenges I face today. Melding science and business wasn’t natural in how I was trained or how I viewed science and medicine. It has become a learned entity for me through on the job training. So I think combining business and science at the undergraduate level is a great concept.”

She elaborated, “Business skills -- basic and beyond -- are going to be required of any scientist at some point, or you can’t have a viable career. Whatever you are doing, it boils down to finding a way to finance it, make an income, and hopefully grow the business portion of a venture to keep the science viable. I wish that I’d had more academic background in what I have since learned on the job. I wish I could have been introduced to the need for this knowledge earlier. Honestly, it never crossed my mind back then that as a scientist and future physician I would also become a business person.”

A prime example of the need to understand business practices is the billing process.

“In nearly every study of emergency medicine billing practices, it shows that when physicians bill, they undervalue their services and tend to decrease charges,” Hearne said. “They somehow feel awkward about fully charging. Most of us went into medicine with an altruistic desire to help others and often don’t blend that well with the business aspect of a monetary value to our services. When third-party billing is done where ‘bean counters’ audit charts and generate bills based on services provided, the billing goes way up. Perhaps a healthier understanding of basic business and an integration of the business concept into the practice of medicine earlier in training would make it more comfortable to meld – rather than isolate – the two entities.”

While Hearne has become much better acclimated to the business side of her profession, she remains driven by the science.

“I am passionate about providing quality care, and all of my decisions are based on what we can do to maintain or improve the quality of the care we provide.”

She said she enjoys taking ownership in the physician group and sees the move away from private practices as “troublesome.”

“It impacts the level of care when large corporations and insurance companies mandate how we care for our patients,” Hearne said. “It is a balance between value and quality.”

Balance is also a key when it comes to her group’s employees.

“We may have the life balance figured out here,” she said. “We don’t want to burn out our people or ourselves. That is a huge problem in emergency medicine and healthcare in general today. We are fortunate to live where we do. We may not earn as much as busier urban practices and may not be able to pay employee physicians as high as elsewhere in the country, but we schedule shifts knowing people have a life and family responsibilities.”

That allows personnel the opportunity to take advantage of all that Vail has to offer. After all, it’s like no place on earth.