R.J.A. Medicentres: Dr. Arif Bhimji, President

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Medicentres is a private physician practice management company that has been operating in Alberta, Canada for more than 30 years now. The founders opened the first Medicentre modeling what they had seen in their home country of England.  The noted that physicians were in accessible and they wanted to ensure that patients could access care quickly and conveniently, but maintain the concept of family practice and continuing cared.  The Medicentres model of non-appointment family practice has been thriving ever since.

Today, Medicentres has over 180 physicians under management and approximately 500 employees. They provide a full scope of health care services out of 26 clinics in Alberta, with fifteen clinics in Edmonton, and nine in Calgary.  They also operate 2 clinics in London, Ontario.

“We tend to work at the fairly large, multi-site group practices and we service a variety of different disciplines including family practice, internal medicine, surgery, obstetrics and gynecology, and pediatrics,” says Dr. Arif Bhimji, President of Medicentres.

The company provides all of the administrative services from patient booking, registration, and billing to management of medical records. They give a physician the ability to join a practice and start focusing on developing their practice rather than having to worry about administration, facilities maintenance and human resource management.

Managing Physician Operations

“We do set strategic directions for the organization, but we want to make sure each individual physician can have their particular needs met,” says Bhimji. “We’ve been able to provide them with flexibility so that they can enjoy their lifestyles while having the freedom to practice medicine. We don’t dictate how physicians practice. We have a variety of practitioners and they are able to fit into the organization.”

Physician tenure with Medicentres is long. Bhimji estimates that at least half of the doctors have been with the company for more than 15 years. Other employees tend to remain long-term, as well. With the recent financial situation, retention has strengthened, which has saved the company costs that would normally be spend on recruiting and new hiring.

An example of strategic direction would be moving all Medicentres to an electronic health record. New centers are opening up with full electronic records in place. Existing centers are being wired, and a measured implementation means taking the time to introduce and teach physicians about the new systems.

“The physicians will have a period of time to adjust, to find out what they need to know about the system before we begin the new reality of electronic medical records,” says Bhimji. “We need to insure that we are providing a superior service to the operations of the company because the operations of the company have to be consistent with what the doctors’ personal needs are and what the needs of the group are.”

Areas of Focus: Physician Recruitment and Site Location

“There is a shortage of physicians here in Canada,” says Bhimji. That shortage is both relative and absolute. There are more positions for physicians than there are individuals to fill those positions. As well, there is the reality that physicians no longer want to work 60 hours a week.  They tend not to work full days or be available all hours of the day, night and weekend to their patients. “Physicians are choosing a lifestyle over a career of service to their practice,” says Bhimji.

Good for physicians, but more difficult for the neighborhood clinic to keep operating at preferred hours for patients. “That is a major issue for us and we have now even gone to looking at recruiting overseas and developing training programs for foreign physicians so they can quality for licenses here. So we are spending money and making the investments in physician recruitment locally, regionally, and internationally now.”

Another area of focus for the organization is in relocating to sites that are more accessible. They are partnering with various other health services such as pharmacy, physical therapy, and dentistry to form health centers that become destinations rather than single service clinics. They are currently opening sites at a rate of about one per year.

“These are all very capital intensive and have to be done carefully,” says Bhimji. “We can’t lose sight of the fact that we are an operational company and that it is the operation that matters.”

Internal and External Modification

The company, though private, is subject to all requirements of Canadian regulatory colleges. Physicians have the requirement of participating in ongoing continuing medical education, for instance, so Medicentres hosts a couple of events a year to give their physicians a convenient way to meet that requirement.

“There are changes that occur within an organization that, of course, have to be accommodated, but more and more we are seeing changes in the external environment which we are not able to control,” he says. Licensing changes have occurred in Alberta that now make it more difficult to recruit foreign medical graduates, for instance, and changes are taking place in the way physicians are being reimbursed.

“We have been effectively left alone within the environment in the past, but all of that is changing because of integration, because of the need to become more efficient within the healthcare system,” says Bhimji. “We have to take into account the external environment much more than we did in the past because of changes that are happening that are fundamental to the way healthcare is moving and being funded and delivered in Alberta.”

Medicentres has been operating for 30 years in a way that is beneficial to patients, physicians and the owners.  We expect to continue operating in this way for the next 30 years.

-by T.M. Simmons

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