Southwest hospitals adding services

BRANSON, Mo. -- In a time when many rural hospitals are struggling to survive, hospitals in southwest Missouri are adding staff and equipment in an effort to keep up with growing populations and to compete with bigger cities' hospitals.

Among Missouri's 143 hospitals and more than 5,000 hospitals nationwide, many rural locations have struggled after cuts in federal reimbursements beginning in 1997, said Dr. Marc Smith, president of the Missouri Hospital Association. But that has not been true in southwest Missouri, he said.

One example is Skaggs Community Health Center in Branson, which has grown from 97 physicians on staff in 1997 to 130 this year. In the past five years, the hospital has attracted specialists from obstetricians to plastic surgeons. The hospital will provide cardiac surgeries by next summer and will provide oncology services within two years, said Chief Operating Officer Don Miller.

"Then there will be no reason for people to pass by Skaggs to go to another hospital," Miller said.

In Springfield, St. John's Regional Health Center is making major improvements to its mid-city campus, renovating buildings and adding equipment, said Chief Operating Officer Jon Swope. St. John's serves 13 counties, including facilities in Hollister, Forsyth, Branson West and two in Branson.

"Clearly, Christian, Stone and Taney counties are very key counties because of the projected growth," Swope said.

Dr. Ron Smalling, a cardiologist who is among the 400 physicians who belong to St. John's Physicians and Clinics Group, said rising costs have made it much more difficult for physicians to have private practices.

"Nationwide, 70 percent of physicians under the age of 40 do not own their own practice," Smalling said. "We take care of people every day who die. At 42, there's something more important to me than owning my own business."

But solo practice was the reason Dr. Melvin Walker left St. John's after 22 years and moved his internal medicine practice to Skaggs in July.

"For me, it was a matter of a chance to refocus on patient care and do a better job of taking care of medical issues," said Walker. He made the change because he said he wants, at age 51, to have a private practice without partners.