Physician technology to assist with ultrasound procedures.
Physician technology to assist with ultrasound procedures.

CV prep

Finding your niche in Baltimore

Table of Contents

Battle of the giants

All of Baltimore’s hospitals operate on a non-profit basis, and the dearth of large systems means most hospitals compete using duplicate services and equipment. Maryland experiences one of the highest cancer rates in the nation, with 22,600 cases reported in 1999. Bon Secours Baltimore Health System, Franklin Square Hospital, Greater Baltimore Medical Center (GBMC), Howard County General Hospital, St. Joseph’s Hospital, Johns Hopkins Hospital, Maryland General Hospital, Mercy Medical Center, St. Agnes Healthcare, Sinai Hospital, Union Memorial Hospital, and the University of Maryland Medical Center each offer everything from screenings to mobile mammography vans to support groups and image recovery centers.

Ditto heart care, where Johns Hopkins Hospital has earned the U.S. News and World Report number 1 ranking since it began ranking the top 100 in 1990. Two city hospitals—Johns Hopkins and University of Maryland Medical Center—perform heart transplants, and eight facilities in the state can perform open-heart surgery. That doesn’t discourage Greater Baltimore Medical Center from pursuing open-heart capabilities. Nor did it stop St. Agnes HealthCare, Bon Secours Baltimore Health System, and Liberty Medical Center from offering interventional cardiology services to West
Baltimore neighborhoods.

“The competitive atmosphere here is fierce,” says Linda S. Dwyer, Greater Baltimore Medical Center’s director of physician recruitment and relations. At least six large hospitals vie for attention in her Baltimore County neck of the woods—with St. Joseph’s not even a mile away.

Part of the saturation stems from patients’ cultural preference to stay in their own neighborhoods, says Brown. “They won’t drive all the way around the beltway. Their health care has to be convenient, close to home and easy to get to,” she notes. Perhaps this is why Kaiser’s HMO staff model found very limited growth in Baltimore because its five health centers were too far apart to encourage citywide access.

Because the majority of doctors settle into private practice, the competition extends to hospital privileges as well. Recruiters report that most family physicians carry privileges at two or three hospitals but tend to admit most of their patients to one. Specialists, says Fedder, also tend to practice at one location, using a second facility as an auxiliary site. However, the specialist’s practice may enjoy privileges at up to five locations as a group.

“Many good hospitals in Baltimore vie for the same patient pool as well as the same physicians,” says Holly Tate, the director of physician recruitment and development at inner city Maryland General Hospital. So the courtship ritual to woo doctors includes everything from university affiliation learning opportunities to troubleshooting and help with HIPAA compliance or OSHA regulations.

“We service our physicians to the hilt, within the law!” Dwyer laughs. “Our department is very customer-service savvy.”

The biggest dogs in the fight, recruiters concur, are the university systems. Johns Hopkins’ medical staff members are almost all full-time faculty of its School of Medicine. As such, the organization is considered a “closed shop” for physician opportunities, according to spokesperson Gary Stephensen. Nevertheless, Baltimore practices can’t help but be affected by its sheer size alone. As of January 1, 2002, the campus formally reorganized the Johns Hopkins Bayview Physicians group into the university to form one of the largest academic group practices in the nation. To date, the $2.25 billion enterprise includes:

• The Johns Hopkins Hospital
• Johns Hopkins Bayview Medical Center
• Johns Hopkins Community Physicians
• Howard County General Hospital
• Brady Urological Institute
• Johns Hopkins Children’s Center
• Sidney Kimmel Comprehensive Cancer
Center at Johns Hopkins
• Wimer Eye Institute

The system recently developed two outpatient centers as well, in East Baltimore and Green Spring Station, the largest freestanding ambulatory care center in Baltimore County. More in White March and Cedar Lane lie on the drawing board.

The technology innovations here are dizzying, the list of famous dazzling. Johns Hopkins Medicine takes credit for identifying a key enzyme in the brain that forms a hallmark of Alzheimer’s disease, and its scientists have successfully used stem cell grafts to restore movement to animals’ paralyzed limbs. They’ve also found a genetic mutation link between sinus infections and cystic fibrosis, and discovered a new gene family that contributes to aggressive prostate, ovarian, lung, breast, and children’s cancers. The hospital’s biennial report reminds donors that NIH awards more research funding to this school of medicine’s faculty than any other.

The University of Maryland Medical Center stacks up favorably against these credentials. Its 1,652 licensed beds and more than 9,000 employees serve approximately 300,000 patients each year. UMMC’s components include:

• The University of Maryland Medical Center
• University of Maryland Hospital for Children
• The Marlene and Steward Greenebaum Cancer Center
• The R Adams Cowley Shock Trauma Center
• Kernan Hospital
• University Specialty Hospital
• University of Maryland Medicine at Timonium
• Maryland General Hospital and Health Systems
• North Arundel Health System
• Mt. Washington Pediatric Hospital

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Julie Sturgeon

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