David Albala, MD
To the best of its ability, Associated Medical Professionals (AMP) of New York, a urology and radiation oncology practice, seeks to give its physician partners an equal share of its financial success while rewarding all staff members according to their levels of responsibility and workflow intensity.
“Finding a solution to make it fair and equitable to all partners is very difficult, especially when there are different referral patterns, geographic areas that have different insurance payers, or simply various specialists in the group,” said Christopher Williamson, chief operating officer.
AMP strives to achieve high standards of quality and motivated employees who commit to making a strong contribution in whatever area of skill and expertise is theirs. “From a business point of view, we want to reward the hard workers that are on the extreme side of productivity or those other physicians that perform the complicated cases, but at the same time those physicians who are in the trenches on a daily basis,” Williamson said. “Every single provider and staff member works together to provide the best care for our patients and achieve financial success for the group.”
AMP now has roughly 30 physicians and 10 clinical locations in 8 counties east of Lake Ontario and Lake Erie. The physicians attend at 9 hospitals throughout the area, and it is these hospital relationships that help to define the staff compensation arrangements.
AMP does not pay physicians incentives. Instead, it has developed co-management agreements with its hospital partners and incentive models are contained within those agreements. These specify goals for AMP to achieve, which are closely measured and ultimately improve patient care and monetary savings for each of the hospitals, Williamson said. “We are essentially partnering with the hospitals, with working toward a common goal.”
Of course, there is no single perfect model, and AMP is always working on refinements. “Everyone contributes in a different way, and when the water rises, the boat rises,” said David M. Albala, MD, medical director and co-director of research at AMP.
History of the Practice
AMP was founded 10 years ago when 2 competing urology groups merged, bringing 11 urologists and 1 radiation oncologist between them. “Essentially, there were 2 large practices that were practicing against each other, so to speak, and they sat down and talked to each other and said, ‘Let’s see what we can do to try to combine forces,’” Albala said.
“The vision of AMP was to merge the urologists in the area under 1 corporate umbrella to develop AMP into a fully integrated healthcare organization in order to provide better continuity of care to patients, while offering the most advanced treatment options and skilled specialists within the system,” said Williamson, who was hired in June 2007 to help with the initial merger and build the practice.
In 2008, the group provided services at 3 hospitals, with the main center located in Syracuse, New York, with 4 offices. The main campus of AMP featured a radiation department and eventually developed a pathology laboratory. Albala, a specialist in robotic surgery, joined the group in 2010.
AMP steadily worked to achieve its larger business objective by combining with nearby urology groups who were competing with AMP. In 2009, 3 urologists who had been in practice together for over 20 years merged with AMP. Their office was about 30 minutes from the Syracuse clinic. From there, AMP started recruiting and adding more physicians, as some older physicians decided to retire. In 2010, 2 more urology groups merged with AMP, with 3 others following suit in the ensuing years.
“Over the course of mergers, there were several offices that were closed down due to the proximity of the other locations to increase efficiency, or for cost-saving measures. Also, by recruiting outside physicians, we were able to expand into other markets that were underserved,” Williamson said. Currently, AMP is the largest urology group in its market. “Patients are able to visit the satellite offices to receive the majority of their care, but at times they need to travel to have the more specialized services,” Williamson said.
“We never envisioned that we would become the only independent private practice urology group in the city of Syracuse and its surrounding counties,” said Howard J. Williams, MD, FACS, CEO of AMP.
In terms of the size of its team, AMP now has 22 physician owners, 6 nonowner physicians, and 300 employees, 275 of whom are full time. AMP does not currently have a medical oncologist but is seeking to recruit one to better accommodate patient needs.