UT Medicine San Antonio: Thomas Mayes, Executive Director

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The doctors of UT Medicine San Antonio are teachers, as well as physicians, and many of them also conduct medical research. The group is an academic medical practice, meaning it is made up of the faculty for School of Medicine of the UT Health Science Center San Antonio. More than 650 providers with 60 specialty and sub-specialty areas of medical practice make UT Medicine the largest physician practice group in Central and South Texas.

The group has been practicing and working as the faculty of the medical school since the school’s inception 40 years ago. “But how we are practicing is changing,” says Dr. Thomas Mayes, Executive Director of UT Medicine. “We’re moving into a more modern era for our physician faculty practice.”

Investing in a Medical Home

The hallmark of that era is a new ambulatory care center, the Medical Arts Research Center (MARC), which opened in August 2009. The 8-story, 280,000 square foot facility cost $106 million and is the largest project the UT Health Science Center has ever undertaken. “It really serves as the focal point and what I call a new practice paradigm for us,” says Mayes.

Until recently, UT Medicine physicians have worked in very traditional academic medicine settings. The majority of physician practice has and continues to occur in Bexar County owned University Health System, the major clinical and teaching affiliate of the UT Health Science Center San Antonio. They also practiced in CHRISTUS Santa Rosa Children’s Hospital and the Audie L. Murphy VA Hospital. Today that practice also includes other CHRISTUS facilities and the Baptist Health System.

“We decided about five years ago to make a big investment in our own facility,” says Mayes. The MARC has 30 different clinics, a state-of-the-art diagnostic imaging system and a complete day surgery suite. The group is also in the midst of upgrading to an electronic medical records system to support the ambulatory practice at the MARC.

Collaboration and Accountability

“We are part of the School of Medicine and I believe we have a very collaborative culture,” says Mayes. “It is extremely important how we deal with our patients. At the same time I have to say that we have not been an organization that has focused, perhaps, on the business of medicine to the degree that we should have. That’s certainly changing with increased accountability for clinical productivity and customer service. We’re seeing better patient satisfaction and really outstanding clinical outcomes for the things that we do.”

Mayes categorizes the group’s business model as fairly centralized, “which adds a layer of ability to monitor and tune things as we need to,” he says. The group takes advantage of economy of scale for things like purchasing. At the same time, clinic staff members are paid for by the individual departments they are representing.

“My biggest challenge as a chief executive in practice plan organization is to keep in place a sense of accountability for the actions of every member of our team, including myself. Our basic function is to assure that patients get high quality, efficient care in a timely manner. At the same time, we are supporting our faculty physicians who have other important roles in addition to  practicing clinical medicine.”

Factoring in divisions of medical school responsibilities and allocations of each physician’s time and effort devoted to teaching and basic research, the 650 providers of UT Medicine are delivering the clinical services equivalent to an estimated 200 full time clinicians. “Managing that faculty model, acknowledging the extreme importance of teaching, is a basic mission for us. The need to create new knowledge through research and, at the same time, to drive a high-performing clinical organization is probably our biggest challenge,” says Mayes. “I have to assure that we balance the missions while being as extremely effective as clinical delivery system.”

San Antonio is the seventh largest city in the nation, but ranks far lower in terms of per capita income. Mayes estimates that 22 to 24 percent of the population is uninsured. UT doctors also serve as the safety net for the community in terms of patients served. “Our population is fragile. Our ability to provide a continuum of services to a population that is underinsured or uninsured is also a significant challenge,” says Mayes.

A New Era of Medicine

“The faculty practice for the school of medicine at UT Health Science Center San Antonio is entering a new era and we are committed to providing the level of care we have provided to our patient base in the past while expanding our patient base in the community. We’ll be supplementing our traditional base of patient care, which has traditionally been in governmental entities. We have made tremendous investments in the facility and in electronic health records in order to help us do things better. We’ve made tremendous investments in terms of adding clinicians, as well,” says Mayes.

“We intend to provide a superior level of care, a one-stop care experience for healthcare and an environment for our patients not available anywhere else in San Antonio. That care will be provided by faculty physicians, the same folks who are teaching the next generation of health care providers and creating new knowledge through cutting edge research.”

-by T.M. Simmons

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