Best Business Practices: Semmes-Murphey Neurologic & Spine Institute

To better understand what those practices look like, we went to a couple of long-standing practices in Memphis: Campbell Clinic (featured last month) and Semmes-Murphey Neurologic and Spine Institute. This month, we jump off with remarks from John Lewis, Semmes-Murphey’s administrator and CEO on how his group stays strong.

Redefine your market

While the majority of their patients come from Memphis, Semmes-Murphey has long offered their services to people beyond the borders of Memphis and Shelby County. When Semmes and Murphey first began practicing in the early part of last century, neurologists were few and far between, so they often received patients via physician referrals. Today, the practice’s reach extends to the greater Mid-South.

“Lots of people can’t get to Memphis, so you come to them,” said Lewis. Hospital administrators also contact the practice to suggest their involvement in a community. The practice provides out-clinic care that way, making physicians available to those who live in more rural communities around the region, where specialized neurological care is limited or unavailable.

Physicians at the Semmes-Murphey’s main office on Humphrey Boulevard see 50,000 to 60,000 patients annually. In addition, the practice runs two smaller locations plus the out- clinics that serve Union City, Desolate, West Memphis, Oxford, Tupelo and Grenada. Practice administrators are currently researching the possibility of further expansion into western Arkansas. To ensure that their arrival is welcomed, however, “We make sure the surgeons there are aware that we want to open an out-clinic, that we want to work as partners with them.”

Stay ahead of the technology curve

With the federal government’s announcement that the health industry would have to move to electronic record keeping by 2015, practice administrators were left with the job to implement this enormous task. Rather than wait until the 2015 deadline was nearer, administrators decided to be proactive. It was 2004 when Semmes-Murphey decided to begin transferring patient data to electronic medical records (EMRs). Since this is a labor-intensive process, they took it one step at a time, inputting data from each patient they saw in a given day until they eventually captured the records of all of their clientele. In 2005, they also went filmless for imaging exams like CT scans and X-rays. The benefit was immediately recognizable.

“Once you’re on the system, you can have access anywhere. If a doctor is home, he can look at a patient’s reports and tests, look at C-scans online of the back or brain,” said Lewis.

“And he can look at these from other locations, too.” Several software updates later, being an early adopter has been hugely successful, reducing administrative costs and freeing up space and funds for patient care. Since keeping files and films was something of a “storage nightmare”, digitizing the data has lead to an impressive office reconfiguration. The square footage once required to house filing cabinets and storage shelves has since been converted into revenue-generating space, said Lewis, “We now have three exam rooms and a physician station where EMR and PAC pictures can be viewed.”

Teach the next generation

With 42 physicians on staff, Semmes-Murphey is one of the largest neurological practices in the nation. The group has had a long and storied association with the University of Tennessee Health Science Center (UTHSC), one that stretches back to practice founder Eustace Semmes, MD, who was the first professor of neurosurgery at UT during the 1930s. Today, a number of Semmes-Murphey physicians continue to serve as faculty members, and don’t limit their training to UTHSC students.

“We’ve got guys that teach and train in other countries,” noted Lewis. He describes Kenan Arnautovic, MD, who routinely travels to his native country of Bosnia to provide free surgical consults to practicing neurosurgeons there. “He trains physicians on new procedures and technology,” said Lewis. He also points to Kevin Foley, MD, a spine surgeon and innovator who teaches internationally.

One of Foley’s innovate ideas gave rise to the Medical Education Research Institute (MERI) in Memphis. Foley was interested in developing ways of doing minimally invasive surgery and making those skills and procedures available to other physicians. With the creation of MERI, a teaching and research laboratory, physicians have an opportunity to learn new procedures. Originally set up to assist with neurosurgery on the spine and brain, physicians now use it to learn a host of surgical techniques in a number of disciplines.

Grow your business

Until recently, neurosurgeons have operated on their patients strictly at the hospital. But as surgeries have become less invasive and more available on an outpatient basis, practices have begun to bring such services in-house. Such is the case at Semmes-Murphey, where many procedures (some involving the spine, carpel tunnel syndrome, and minor exploratory surgeries) can be done in-house at the practice’s surgical center. The advantages are many: convenience for both patients and doctors, the streamlining of medical record keeping, cost containment and quality of care. The center opened in 2002 and cost $7 million to build but it was a cost-effective move for the practice. “It’s more convenient because doctors can see patients in clinic and operate, we can offer post-operative care, and you’re going to get better care here than you will at a hospital.” 

Though it took a substantial investment of funds on the front end to outfit the center’s three operating rooms and nine recovery suites, Lewis believes this is the direction medicine is headed. The surgical center is also accredited by the American Association of Ambulatory Health Care Centers – a step that wasn’t required but was taken by the practice to ensure that standard of excellence was being maintained.

“That is your qualitative metric. What it says is that you’ve gone to the trouble of ensuring that you’ve got a quality process in place for treating patients. And that you practice quality medicine. That’s what we do.”

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