HEALTH: HOSPITAL TO RUN PROGRAM

Dr. Matthew Shepard checked the vital statistics of a dying 69-year-old Cape Girardeau patient. Because the patient didn't have his own doctor, he was assigned to Shepard -- a "hospitalist" assigned specifically to such cases.

On Wednesday, Shepard, an internal medicine sub-specialist, attended to patients at both the St. Francis Medical Center and Southeast Missouri Hospital in the hospitalist partnership program between the hospitals. By July, Southeast will leave the two-year partnership to start its own hospitalist program, leaving Shepard and five colleagues to choose between the programs.

Southeast president James Wente said hospital's new hospitalist program won't differ from the the current program, other than hiring an additional hospitalist.

Wente said the choice is the hospitalists' if they want to join the Southeast program.

"We're not going to pursue them, but if they choose to work at Southeast, that's their prerogative," he said.

The specific date of separation is not known.

A Nov. 6 letter from Wente to St. Francis president Steven Bjelich announced Southeast's intent to withdraw from the partnership by July 1. A notice of 180 days is required for an institution to leave the partnership, said Bjelich.

The letter surprised hospitalists and St. Francis administrators.

"For five minutes, I couldn't pick my jaw up off the floor," Shepard said. "I was flabbergasted."

Bjelich said St. Francis is prepared to assume the full costs of the program. With six physicians' salaries and benefits, that's a base expense of $1 million a year.

Shepard said the good thing is he will no longer have to drive between the two hospitals to visit patients.

News of the separation was posted at Southeast on Wednesday.

Hospitalists are the fastest-growing group of internal medicine sub-specialists, said Shepard. The term "hospitalist" was coined in a 1996 New England Journal of Medicine article.

The growth of the sub-specialty has exploded since the mid-1990s and appeals to doctors who would rather treat chronic illnesses than the minor complaints routine to outpatient clinics.