Joralemon Street Practice Affiliated with Weill Cornell
With the passage of the Affordable Care Act (also known as Obamacare) and the closure of major hospitals such as Long Island College Hospital (LICH), it’s not news that health care is being disrupted in Brooklyn.
The state is placing new emphasis on primary care and Accountable Care Organizations (ACOs), along with a concept known as “medical homes,” with the intent to improve the quality of health care and cut costs.
Brooklyn rheumatologist Dr. David Goddard, former section head at LICH, says that to adapt to these changes, doctors need to come together in groups. So, in collaboration with Weill Cornell Medical College, he is putting together an integrated physicians group with a focus on primary care at 186 Joralemon St. in Brooklyn Heights, with another branch in Fort Greene and other locations in the works.
The practice occupies three and a half sparkling floors in the Joralemon Street building, several newly renovated. Another basement space is used for rehab, said Dr. Goddard, who led a tour of the facilities.
Many of the group’s doctors — including primary care physicians and subspecialists — previously practiced at LICH, and others were hand-picked by Dr. Goddard.
“We are an integrated group who have all served the Brooklyn community for most of our professional careers and are dedicated to excellence in health care for the borough of Brooklyn,” Dr. Goddard told the Brooklyn Eagle.
“I’ve got six primary care docs upstairs. We’re talking to another community-based physician from Brooklyn Heights who I hope will decide to join us, and there are people I know from working with over the years who are quality physicians,” he said. “There are a couple of groups up on Eastern Parkway, for example, and a couple of groups down in Cobble Hill. So it’s putting these blocks together.” In Fort Greene, Drs. Ron Dailey and Jed Burack head the six-member group at Sunrise Medical, 55 Greene Ave.
Besides the nucleus of primary care, the practice includes a gynecologist and an endocrinologist.
“We’re setting up right now a diabetes program,” Dr. Goddard said. “We recruited a nephrologist from Sinai, who is absolutely super. I have a neurologist who’s part of the Cornell faculty seeing patients here; and a cardiologist from Cornell, also seeing patients here. I have a physiatrist, and we will be recruiting or will have dermatology, geriatrics, hematology, oncology, and we’ve got a pulmonologist who’s coming.
“So in other words, I’ve got all of the services on site and on Greene Avenue. And it means that instead of people trekking here, there and everywhere else, I can now say to someone, ‘I really need you to see the neurologist. He’s going to be here on Monday. Let’s get you an appointment for Monday.
“What I want to do is get to a point where we have a nucleus of maybe 30 primary care physicians,” Dr. Goddard continued. “And what I’m really looking to do is to have responsibility for providing care for about 100,000 insured lives. Those are the sorts of numbers we’re going to need if we’re going to be an effective part of an Accountable Care Organization.”
Dr. Goddard said the practice would continue to grow “using the concept of practice without walls.”
“You don’t need to have people physically located all in one spot in order to deliver integrated care. What you have to do is have them linked by commonality of purpose, and also by using the same methods for practice — mainly the same electronic medical records platform. So if I have a patient go to see somebody on Greene Avenue, I’m looking at the same record over here as they’re looking at over there,” he said.
Forming an integrated physicians group has enormous benefits for patients, Dr. Goddard said. “Everybody is on a common platform; there’s less room for error in terms of mistakes with that information. But more importantly, what it also means is that if I see a person who’s a patient of, for example, Eileen Rassi upstairs, I know exactly what’s going on with that patient. I know exactly what medications that patient is on, and where there may be sensitivities to different medications. And what it does is reduces the risk of error.”
It also eliminates unnecessary duplication of medical tests, he said. “It makes it much more economical in terms of health care.”
Dr. Goddard says that Weill Cornell shares the group’s vision and commitment.
“Cornell came and said, ‘We’re interested in establishing a presence in Brooklyn, and we’re not interested in managing your practice. But we are interested in the fact that you know the community and you’ve been successful,’” he said.
Dr. Goddard said the practice planned to become a “medical home” facility in 2015. “What this is, is the concept of a caregiver who then takes responsibility for a particular problem,” he explained. “A good example of this would be diabetes. In a medical home, you’re identified as the primary caregiver, and you’re responsible for managing diabetes in that individual.”
He emphasized that the group is not a substitute for an emergency room. “If this is emergent, if this is acute, you need emergency room services. But we don’t do that. We’re interested in providing primary care and subspecialty care.” He also explained that the group does not provide urgent care, like the nearby Mount Sinai facility.
If patients need emergency admission, “they’re going to go to local hospitals,” he said. “It actually turns out the closest emergency room to us geographically here happens to be New York Presbyterian Lower Manhattan,” (formerly New York Downtown) now an affiliate of Weill Cornell which uses the same electronic health record platform.
New York Downtown, at 170 William St., is the only hospital left serving lower Manhattan. It has 128 beds, according toU.S. News and World Report.
When asked what he wanted the Brooklyn community to know about the physicians group, Dr. Goddard said, “That we care about the community, that we care about making sure that the community enjoys better medical services than they’ve enjoyed before, and that we would like to be your healthcare provider.”
He added, “I’m going to have good services. My daughter and husband bought a loft off Fulton Mall, so I have to.”
Weill Cornell Physicians at Brooklyn Heights
186 Joralemon Street, 8th floor
Brooklyn, NY 11201
646 962 4656