Conversation with a leader

Wednesday, February 8, 2006 at 1:00am

Micail L. Samiere is the chief operating officer of Nashville-based physician group Urology Associates, P.C. Originally from Los Angeles, Samiere obtained her bachelor's degree in finance from California State University-Fullerton and her master's in business administration from California State University-Long Beach. A certified medical practice executive, Samiere began her health care career managing a large multi-specialty, mixed-model medical group in Los Angeles for AHI Healthcare Systems, Inc. She was recruited to Nashville in 1994 to start a practice management company for HealthTrust, Inc., the second largest for-profit hospital system in the country at the time. That company was subsequently purchased by HCA, and Samiere moved to HCA to serve as an executive director of practice management. Samiere has served as a director of operations for PhyCor as well as the COO of The Heart Group. UA, which recently introduced its Women's Institute for Sexual Health, has 20 locations throughout Middle Tennessee and Southern Kentucky.

What has been Urology Associates' main operational challenge?

We have to constantly modify our operating and business strategy to respond to the changes in the reimbursement environment. And that's true of any medical entity.

Have you instituted any procedures or personnel changes to address this?

Regarding personnel, we operate much more leanly than we did in the past. We have about 140 employees who work for our medical group and surgery center. Over the past few years, we've had to divert more of our resources to administrative requirements that are imposed by the insurance industry.

How do you view UA in relation to other members of Nashville's health care industry?

The Nashville market is full of health-care innovators, and we are a part of that. The medical groups are being challenged to distinguish themselves now. We welcome that challenge through the quality and depth of service we provide. Because we are the largest urology group in Nashville, we have an opportunity to have many of our diagnostics done on site. And we have a specialty specific surgery center on site. This also gives us the ability to stay on the leading edge of technology because we have the volume of patients to support it. We have 27 physicians who practice within this group, which has been in operation since the 1940s.

In 2000, Urology Associates sued CIGNA Corp., alleging the company had failed to properly compensate UA. Can you comment?

"I can only say that the matter was settled to the satisfaction of both parties."

What are UA's strengths?

Innovation and flexibility. The physicians in UA have taken business risks that have worked out well. From a clinical standpoint, they have embraced new technology. And the group has a real estate partnership and has built its own building.

What is UA's main shortcoming and how are you addressing this?

We had to admit that physicians historically have not had a cohesive voice. The members of our group have acknowledged that they probably haven't historically been as active as they should have been with regards to policy-making in the State of Tennessee. So we have made a commitment to be involved in the political process, to be involved in decision-making.

How much progress has the Women's Institute for Sexual Health made during its brief existence?

We had an aggressive time-line as far as getting the service up and running. In September, we hired Brooke Faught as our director. She was brought on board to develop a service that did not exist in Nashville at the time. WISH, which opened its doors in November 2005, currently has three employees, and we foresee that number growing quickly once we have increased community awareness. Brooke has already helped a number of women in Nashville. And those referrals came from physicians in the community.

Why was WISH started?

The reimbursement environment has encouraged us to be innovators in looking at ways to increase our service to the community. We discovered that this was an underserved area. No local health care entity was focused on women's sexual health. It's not widely known, for example, that female sexual dysfunction is more prevalent than male sexual dysfunction. As a urology group, we have always treated male sexual dysfunction. Much of female sexual dysfunction involves the urinary tract, which is our specialty. For WISH, we carved out space within our existing building. We wanted an environment that was private and comfortable.

What type capital investment did Urology Associates make to institute WISH?

There was no substantial capital investment for infrastructure. The largest investment has been in personnel.

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