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September 5, 2003
USA sees Knollwood as its major academic medical campus Doctors moving as USA shifts focus to Knollwood

By JEFF AMY Staff Reporter

University hopes changes will bring in more privately insured patients, boost cancer cente.

Dozens of doctors at the University of South Alabama will move their offices out of the central building on the main campus to the three outlying USA hospitals by 2005.

The largest number of doctors will be going to USA's Knollwood Hospital, where they will have their academic offices as well as clinics for seeing non-hospitalized patients, part of the school's plan to transform the southwest Mobile hospital into the focal point of its health system, top USA officials said.

University officials said they hope the change will help the school attract more privately insured customers, ease accreditors' worries about the spread-thin nature of doctors at USA's small medical school and bolster USA's fledgling cancer center at Knollwood.

USA trustees agreed Thursday to buy a medical office building across the street from Knollwood from two local orthopedists for $950,000.

"It will establish Knollwood as our major academic medical campus for the future," said Dr. Robert Kreisberg, dean of USA's College of Medicine.

The emptying of the USA main campus physician office building, known as the Health Services Building, could provide room to move USA's College of Allied Health Professions and College of Nursing to the main campus from the school's Spring Hill Avenue campus. President Gordon Moulton has made a goal of such a move.

The 13,000-student university operates two facilities at Knollwood, a regular acute care hospital with 124 beds and a long-term rehabilitation hospital with 191.

The Knollwood acute care hospital is the smallest of the six hospitals in Mobile. USA Children's and Women's Hospital has 152 beds, and the USA Medical Center has 346 beds. Kreisberg said the new emphasis will alter Knollwood.

"We have to change it from a sleepy community hospital to a high-powered academic medical center," Kreisberg said.

Moulton said USA won't settle on a use for the main campus building until after officials consult with a campus planning firm. He said that even if allied health and nursing move to the main campus, he anticipates that USA will continue to operate its pediatric and family medicine clinic on Spring Hill Avenue for the foreseeable future. The Spring Hill Avenue facility is close to USA Children's and Women's Hospital.

Medical professors who research and teach in non-clinical departments, as well as most medical-student classroom instruction, will remain on the main campus at University Boulevard and Old Shell Road.

A group of internists already has moved to Knollwood. They will be followed by most surgeons, medical specialists such as cardiologists and orthopedic surgeons.

Smaller numbers of doctors will move to USA Children's and Women's and USA Medical Center. Those going to Children's and Women's will include obstetricians and gynecologists who currently see patients on the main campus.

USA Medical Center will remain focused on trauma cases and transplant cases.

Kreisberg said the idea is to reduce shuttling back and forth from hospitals to offices on the main campus. "The faculty will be deployed primarily by how much time they spend at each hospital," he said.

The Liaison Committee on Medical Education, which accredits medical schools, criticized USA's scattered clinical faculty following its visit to the campus last fall, saying the dispersion saps their research ability.

"This limits the capacity of relatively modest-sized clinical faculty to contribute substantially to the scholarly mission," a six-doctor survey team wrote.

Kreisberg said the move coincided with but was not caused by the LCME's criticism. He denied another finding of the accrediting body, that USA doesn't have enough clinical faculty in some medical disciplines. Kreisberg said USA has about 120 clinical faculty members today. The LCME report said USA had 197 in 1995.

The medical school does have plans for growth, which centers largely on the cancer center planned for Knollwood. A construction manager was hired Thursday to oversee the erection of a cancer center building there. Part of the reason for moving doctors there is to make sure the hospital has the ability to treat all the illnesses that cancer patients develop.

The move also could help USA capture more privately insured patients. Traditionally, USA has treated three-fourths of uninsured patients in Mobile County and many others who rely on Medicaid, a federal program that pays less than private insurance. That's in part a consequence of USA Medical Center being the closest hospital to many poor neighborhoods. But Knollwood is in a more affluent area.

"If we're going to succeed in our mission, we have to make enough money in activities where we can get reasonable reimbursement to support the whole mission," Kreisberg said. "We also have to attract more patients that have better payment capabilities."

Kreisberg said a new physicians' office building will be needed at Knollwood within three years. For now, though, doctors will squeeze into the three existing physician office buildings and the new purchase, which will get new paint and carpet.

Moulton said that USA could not have built space for the $50 per square foot it will spend to acquire the building. "Ultimately we'll be looking at building additional clinical facilities, but this is an excellent bridge," the president said.

Alabama Orthopaedic Clinic, which currently occupies the medical office, is consolidating operations in a South Beltline Highway building, which the clinic is constructing jointly with Springhill Medical Center.

The two-story, 18,572 square-foot building is owned by Dr. Suanne White-Spunner and Dr. Robert Zarzour. The pair were partners in one of the orthopedic practices, which merged to become Alabama Orthopaedic Clinics in 1996, and still practice in the Knollwood building.

Moulton said the building had been appraised at $2.3 million. The Mobile County Revenue Commissioner puts its market value at $1.04 million. Moulton said the owners would get a tax break for selling it below appraisal to the university.

Zarzour declined to discuss the sale.