Tom Simmons

• 
  Hospitals & Health Networks - Article Display - [Cached Version]
  Published on: 10/1/2000    Last Visited: 3/18/2001  

  Tom Simmons , CEO of Collom & Carney Clinic Association in Texarkana , Texas , tells of a gynecologist who retired last March.Unable to sell his practice , the doctor finally gave his 5 , 000 patient records to the clinic.Ten years ago , this would have been unheard of , says Simmons.In the past , some doctor would have snapped up the practice for $ 300 , 000 to $ 400 , 000.Meanwhile , Simmons tries to recruit a gynecologist ; the clinic's other doctors in that specialty are already busy.
  
  One problem with replacing the newly retired doctors , says Simmons , is that younger doctors often are unwilling to work the strenuous schedules shouldered by their forebearers.
  ...
  In some ways , Simmons is lucky ; he's not facing an avalanche of retirements anytime soon.The average age of Collom & Carney's 65 doctors is 40.But Simmons isn't sitting on his hands.He's seen the average age of retirement fall from 67 to 61 in the last decade , and thinks it will go even lower : many of the clinic's 40-something physicians say they'll quit in their late 50s.
  
  To prepare for the exodus , Simmons is recruiting doctors in eight specialties now , even though he has only two doctors retiring in the next three years.We may overbuild in the short term , he says.But we are trying to get ahead of the curve.We're not finding anything easy..
  
  And Smith says he doesn't expect things to improve for executives like Simmons , whose clinic is in a second-tier market--those with a million or less in population.

• 
  LeadDetail - [Cached Version]
  Published on: 10/29/2000    Last Visited: 10/29/2000  

  i have been here 10 years, and in that time, we have had four or five physicians retire, with most of them working until between the ages of 65 and 70, says Tom Simmons, CEO of Collom & Carney Clinic Association, a 66-physician medical clinic in Texarkana, TX.But that was the prior generation.A year ago, Simmons reports, we took a survey related to our defined benefit pension plan, asking physicians what their plan for exiting was.And we found that the average projected retirement age was 61 ; before that, it had been 67 to 68.And 20 % of them were saying they would retire at ages 55 to 59.So we may not see this in two or three years, but in the next 10 years, we will see a tremendous shortage of doctors, he predicts.
  
  ...
  A number of factors are coming into play, as far as Simmons and his colleagues are concerned.
  
  For one thing, Simmons notes, the physicians now have more financial flexibility, and have accumulated more assets than the previous generation.Second, the fun of medicine is declining.A lot of this is based on managed care hassles, some on unrealistic patient expectations, some on a difficult medical-legal environment, some on declining reimbursements..
  
  And the other factor, he says, is an ongoing increase in the numbers of women physicians.About 8 of the 66 physicians at Common & Carney now are women, Simmons says, and they are excellent clinicians ; but they have also made it clear that they want to balance their practice hours with family and personal responsibilities.Finally, Simmons says, he sees the quality of medical school graduates declining over time, as the boom in high-technology fields siphons off some students who might have chosen medicine but are now doing things like Internet start-ups.
  
  Given that 10 % to 20 % of the physicians here in Texarkana are substantially dissatisfied with the system, and the remaining 80 % are moderately dissatisfied with the system, Simmons says, the whole situation looks actually rather grim when projected several years into the future.And that be in a market with no capitation and 80 % discounted fee-for-service reimbursement.
  
  ...
  For Simmons, it be gastroenterology, oncology, hematology, and rheumatology that are the problem areas.But, Simmons notes, the future in those areas is already quite problematic.There are about 180 residents coming out of their residencies annually now in hematology nationwide, and about 150 in oncology, as a broad guesstimate.In any case, when you spread those numbers across the United States, it makes for a very tough situation.that be three or four per state, and that be not very much..
  
  ...
  At the same time, Simmons says, it be very clear that, for the foreseeable future, the challenges will remain primarily on the specialty side, and not on the primary care side.Most of our needs will be in subspecialty medicine, with very limited needs in primary care medicine, for the next several years.And that be just the reverse of where everyone thought we were going several years ago.Five to seven years ago, there was such a push toward primary care that a lot of medical schools put an emphasis on primary care.And now, here, there are substantially more primary care doctors than we need, and significant, ongoing specialist shortages..
  
  Given all this, what strategies can physician-based organizations adopt in the next several years to avert a specialist crisis in their organizations and markets.

• 
  MDoptions - [Cached Version]
  Published on: 6/28/2002    Last Visited: 12/11/2005  

  "Those crucial strategies establish a culture that promotes productivity," says Tom Simmons, the clinic's CEO.Physicians need to understand those four elements and how they relate to their compensation, Simmons explains."We reward physicians for the value of the services they provide," he says."We make sure they understand productivity goals and standards and how the compensation plan works.Above all, we want them to view our reimbursement procedures as fair."A physician who is willing to emphasize productivity can increase his or her income, says Simmons.The physicians are paid based on the volume of work they do or the number of patients they see, he explains.

• 
  MGMA - Effective Production, Capacity, and Staffing - [Cached Version]
  Published on: 2/21/2001    Last Visited: 9/30/2007  

  "The key to our success," says Tom Simmons, CMPE, Chief Executive Officer at Collom and Carney, "is our physician selection criteria.

• 
  Medical Group Focus Speakers - [Cached Version]
  Published on: 5/3/2006    Last Visited: 9/30/2007  

  Tom Simmons, CMPE
  
  Administrator
  
  Collum & Carney Clinic Association

• 
  NEJM CareerCenter: Doctor Dearth: Physicians Retiring... - [Cached Version]
  Published on: 7/1/2001    Last Visited: 7/31/2008  

  Tom Simmons, CEO of Collom & Carney Clinic Association in Texarkana, Texas, tells of a gynecologist who retired last March.Unable to sell his practice, the doctor finally gave his 5,000 patient records to the clinic."Ten years ago, this would have been unheard of," says Simmons.In the past, some doctor would have snapped up the practice for $300,000 to $400,000.Meanwhile, Simmons tries to recruit a gynecologist; the clinic's other doctors in that specialty are already busy.
  
  One problem with replacing the newly retired doctors, says Simmons, is that younger doctors often are unwilling to work the strenuous schedules shouldered by their forebears."The old-school doctors had an expectation of working 60 to 80 hours a week and they spent their careers doing it," Simmons says.But for some younger physicians, an easier lifestyle takes precedence over generous compensation."It doesn't matter how much money they make if they are on call every other night," he says.A case in point: he plans to hire two surgeons to take the place of one who labors 80 to 100 hours a week.
  
  Planning Ahead
  
  In some ways, Simmons is lucky; he's not facing an avalanche of retirements anytime soon.The average age of Collom & Carney's 65 doctors is 40.But Simmons isn't sitting on his hands.He's seen the average age of retirement fall from 67 to 61 in the last decade, and thinks it will go even lower: many of the clinic's 40-something physicians say they'll quit in their late 50s.
  
  To prepare for the exodus, Simmons is recruiting doctors in eight specialties now, even though he has only two doctors retiring in the next three years."We may overbuild in the short term," he says.

• 
  NEJM CareerCenter: Doctor Dearth: Physicians Retiring... - [Cached Version]
  Published on: 2/8/2004    Last Visited: 9/16/2004  

  Tom Simmons, CEO of Collom & Carney Clinic Association in Texarkana, Texas, tells of a gynecologist who retired last March.Unable to sell his practice, the doctor finally gave his 5,000 patient records to the clinic."Ten years ago, this would have been unheard of," says Simmons.In the past, some doctor would have snapped up the practice for $300,000 to $400,000.Meanwhile, Simmons tries to recruit a gynecologist; the clinic's other doctors in that specialty are already busy.
  
  One problem with replacing the newly retired doctors, says Simmons, is that younger doctors often are unwilling to work the strenuous schedules shouldered by their forebears."The old-school doctors had an expectation of working 60 to 80 hours a week and they spent their careers doing it," Simmons says.But for some younger physicians, an easier lifestyle takes precedence over generous compensation."It doesn't matter how much money they make if they are on call every other night," he says.A case in point: he plans to hire two surgeons to take the place of one who labors 80 to 100 hours a week.
  
  Planning Ahead
  
  In some ways, Simmons is lucky; he's not facing an avalanche of retirements anytime soon.The average age of Collom & Carney's 65 doctors is 40.But Simmons isn't sitting on his hands.He's seen the average age of retirement fall from 67 to 61 in the last decade, and thinks it will go even lower: many of the clinic's 40-something physicians say they'll quit in their late 50s.
  
  To prepare for the exodus, Simmons is recruiting doctors in eight specialties now, even though he has only two doctors retiring in the next three years."We may overbuild in the short term," he says.
  ...
  In Texarkana, patients wait 90 days to see a rheumatologist or a neurologist, and CEO Simmons fears the wait will lengthen even further if he doesn't fill the holes in his physician staff.

• 
  NWANews.com - Northwest Arkansas News on the web - [Cached Version]
  Published on: 2/3/2002    Last Visited: 2/3/2002  

  Collom and Carny, a 70-physician Texarkana practice with clinics in Hope, Magnolia and Nashville, recently sought malpractice insurance proposals from 30 companies but got just three offers, said Tom Simmons, the company's chief executive officer.
  
  Simmons said normal response rates hover around 50 percent.
  
  "There are only a handful of companies willing to write malpractice business," Simmons said."It's very much a seller's market at this point."
  
  Despite earning what Simmons called "a spotless track record," Collom and Carny still watched rates climb 120 percent in the past two years.
  
  The four doctors at Paragould's Family Practice Clinic recently signed on with Tennessee's State Volunteer Mutual Insurance -- now the largest insurer in Arkansas -- after being dropped by St. Paul.Although their rates increased 30 percent, doctors at the clinic say worse is to come.

• 
  QIPhysician.com | Quality Performance - [Cached Version]
  Published on: 8/19/2002    Last Visited: 8/10/2003  

  "Those crucial strategies establish a culture that promotes productivity," says Tom Simmons, the clinic's CEO.Physicians need to understand those four elements and how they relate to their compensation, Simmons explains."We reward physicians for the value of the services they provide," he says."We make sure they understand productivity goals and standards and how the compensation plan works.Above all, we want them to view our reimbursement procedures as fair."A physician who is willing to emphasize productivity can increase his or her income, says Simmons.The physicians are paid based on the volume of work they do or the number of patients they see, he explains."Our physician volume is higher than industry averages, so our reimbursement model is also higher," he notes."Our physicians earn more because they work harder."The emphasis on hard work requires Collom & Carney to recruit physicians who have a work ethic that parallels that of the group, Simmons says.
  ...
  In other words, the physicians work to match resources to production requirements, Simmons says.One of the most significant keys to productivity is the physician compensation formula.Approximately 80% of this formula is based on work units, or the amount of collected revenue each physician generates.The remaining 20% is determined by an even split of department profits after subtracting expenses.Also, the group considers ancillary revenue from laboratory and radiology services as a production credit and accounts for malpractice insurance as a general expense, not as a departmental expense.Malpractice insurance payments can be contentious in a multispecialty group because the rates can vary widely among specialties."Most medical groups consider the issue of who pays whose malpractice insurance to be controversial," Simmons explains.
  ...
  At Collom & Carney, physicians who fail to reach their goals meet with an administrator to discuss the monthly reports, the goals, and the actions the physicians could take to improve their results, Simmons explains.Each January, the executive committee reviews the formulas used for profit distribution and makes adjustments as necessary.Such adjustments help prevent substantial income variations from year to year."We quickly learned that physicians, like everyone else, have an aversion to large swings in income," Simmons says.Staff RetentionRetaining staff is one way to avoid large swings in income, according to Simmons.Because staff retention is an important element of maintaining high production and quality care, the clinic's compensation plan is designed to help the group retain staff over time, he notes."All physicians are employed with the hope that they will retire in the organization," Simmons says."If that is not achieved, the clinic feels both parties have failed to meet their goal."After 20 years, a physician will be vested in the company's stock ownership and pension benefit plans, and each can be significant.The clinic's attrition rate among physicians is only about 5% a year.Attrition among midlevel staff, including nurses, is also low, partly because their compensation is related to productivity and is therefore higher than industry norms, Simmons says."The key to our highly productive corporate culture is that we develop compensation incentives that benefit all our employees, not just doctors," he adds.Such incentives are based on productivity increases and departmental profitability.Midlevel providers not only boost physician productivity, they also improve patient satisfaction, according to Simmons."Initially, our physicians were negative on employing midlevel providers," he says.
  ...
  For Collom & Carney, increasing production is a basic objective, says Simmons.Physicians have the option, for example, of hiring a second nurse to help increase their productivity, he says.The clinic absorbs the cost of one nurse, but the cost of the second nurse is deducted from the individual physician's earnings.The clinic has found that whenever one of its physicians hires an additional nurse, the physician's productivity increases, says Simmons."That seems somewhat counterintuitive, and MGMA studies have shown that increased staffing can increase costs without increasing revenue, but our highest earners make the decision on their own, and invariably, their income goes up," he says. It is no coincidence that the clinic's patient volume is higher than that of MGMA's average for multispecialty groups, and so is its compensation."With an emphasis on productivity, increased compensation falls into place, and with that comes lower attrition, more efficient service, and better medicine," says Simmons.

• 
  Texarkana Gazette: News - [Cached Version]
  Published on: 9/14/2003    Last Visited: 9/14/2003  

  Collom & Carney's current administrator Tom Simmons said from the clinic's humble beginnings in 1947 with six or seven physicians, it has expanded to 72 doctors and more than 500 employees who serve more than 200,000 patients.
  
  "He continued to be active right up until his death," Simmons said of Carney.

Page:  1 2