UCLA: ‘Aggressive’ Expansion in Primary Care Angers Local MDs
In the past decade, UCLA has expanded beyond its campus hospital to win a 20% medical market share in west Los Angeles through an aggressive growth strategy that has angered some local care providers, the Wall Street Journal reports. The conflict pits UCLA against physicians not affiliated with the medical giant who feel that the system is "driving physicians out of business" and taking "unfair advantage" of its status as a publicly funded institution to pursue its expansion. In the early 1990s, UCLA was viewed as a "benign presence" on the medical scene, a traditional academic medical center. But then managed care penetration grew and HMO patients were increasingly being referred to lower-cost community hospitals; at the same time, state officials began urging UCLA to train more primary care physicians to balance a glut of specialists. Worried it would lose the patient volume necessary to train its faculty, UCLA resolved to change its strategy and began building up its primary care network.
Despite assurances that their "independence wouldn't be threatened," local physicians "quickly grew nervous" as they saw referrals "evaporate" when UCLA's family practices began referring patients to UCLA specialists, the Wall Street Journal reports. Other physicians claim UCLA threatened them with loss of their practices unless they joined the university's staff. In 1998, a group of 14 anesthesiologists sued the system to block it from "illegally forcing" them to become employees. The California Medical Association joined the lawsuit, claiming the system violated a state law banning "the corporate practice of medicine," but an appeals court ruled in favor of UCLA in March, citing community benefits from UCLA's expansion. Dr. Rick Welcome, a "disgruntled" radiologist who went to work for UCLA three years ago but is now quitting his job, said, "What UCLA is doing is no different from a corporation that takes over a supermarket." For its part, UCLA defends its market strategy. Gerald Levey, dean of the UCLA School of Medicine, said, "This hospital was in deep trouble in 1990 and 1991. If we sat here and did nothing, I can tell you we would be closed" (Rundle, 8/15).