Magazine article The Exceptional Parent

Phoenix Pediatrics: Using History to Create the Future

Magazine article The Exceptional Parent

Phoenix Pediatrics: Using History to Create the Future

Article excerpt

On a hot spring day, Dr. David Hirsch labors to perform an intricate surgical procedure--on his rooftop cooling system. Take away his medical degree and years of practice as a pediatrician, and you'll find a mechanical engineer who harbors a deep love for the precision and beauty of numbers.

Dr. Hirsch began his engineering career in aircraft design, patented several inventions, and then became intrigued with biomedical engineering while working with a physician to design artificial finger joints. Medical school was the next logical step.

While doing his residency at the University of Michigan, Dr. Hirsch was influenced by Dr. Mason Barr, a dysmorphologist. (A dysmorphologist studies genetic syndromes characterized by physical malformations. Dr. Ban's way of relating to the whole child and family, was uniquely compassionate.) When setting up his own practice, Dr. Hirsch purposely set out to combine the compassionate healer with the analytical engineer.

As far back as 1981, Phoenix Pediatrics was collecting data and storing it on computer. Computers then took up entire rooms requiring special climate controls, and held only a fraction of information that the modem desk-top version does. For 17 years, Phoenix Pediatrics has been collecting and storing information on children with special health care needs, including diagnosis, number of annual office visits and hospitalizations, length of and reason for hospitalizations, type of equipment and supplies needed, types of illnesses treated, type and amount of related health services required, and the cost of providing care.

With this data, Phoenix Pediatrics is able to predict future costs of caring for a child with special needs. From their large patient base, they can access the data on patients with a specific disorder, for example, and see a record of what care, procedures, or equipment those children needed through the years. By adjusting for today's prices, the Phoenix group can make an educated estimate as to what costs will be incurred for treatment.

This ability has been responsible for moving the practice toward a goal of decreasing health care costs while constantly improving services to the child and family. Current data shows that by neither over-estimating costs (and consequently driving up the cost of health insurance premiums) or under-estimating costs (and perhaps having insurance providers lower coverage limits) the Phoenix group has successfully met efficiency goals and lowered costs, all while providing better care.

Spend now, save later

In making financial decisions regarding which medical practices they will contract with to provide services, insurance companies, state governments, and other payors tend to look at the monthly bottom line rather than the long-term cost. Phoenix Pediatrics is in a unique position to show these entities that there is a long-term savings achieved by paying for preventative health care and maintenance. The group analyzes annual and semi-annual costs, which in turn are examined in light of previous annual costs for that child and other children with the same diagnosis; the trend is analyzed and compared to past data so that future costs cart be projected. The data shows unequivocally that money spent on children when they are young, can prevent larger costs later in life.

Although advocacy for a proactive health care model is currently still an uphill battle, Dr. Hirsch believes the trend is positive as we move toward the "medical home" model recommended by the American Academy of Pediatrics. …

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