In a day when medical care is consolidating and smaller practices are being eaten up by larger groups, two Stony Brook Eastern Long Island Hospital doctors are going in the opposite direction.
Dr. Dhiren Mehta, a gastroenterologist, and Dr. Frank Adipietro, a pain specialist who lives on Shelter Island, have opened the North Fork Surgical Center in Southold to offer outpatient procedures in their practice areas.
It has been a four-year effort, culminating in a Valentine’s Day notice that the two physicians received the last approval from the New York State Health Department to function at offices on Boisseau Avenue in Southold.
“It was easier getting a medical degree,” Dr. Adipietro said about the hurdles both had to overcome to make their plan a reality.
There were multiple applications that had to be filed, plus numerous hearings and inspections. They needed permits from Southold Town, Suffolk County and New York State.
Asked why they put themselves through such a bureaucratic ordeal, the doctors said that insurance company requirements refusing payments for some procedures within hospitals or cutting back on payments and hitting patients with high co-pays, largely forced them to start the practice.
“We want to provide top level care at an equitable price” to people on the East End, Dr. Mehta said.
They can offer top level medicine with co-pays that will be less than half of what they have been assessed by their insurance companies, Dr. Adipietro said.
Both doctors accept a wide range of insurances, including Medicaid, so no patient has to be refused treatment.
At the same time, in rare cases where there could be expected complications or where a patient prefers treatment in a hospital setting, patients can still have procedures done at Southampton Eastern Long Island Hospital, they said.
The idea started with Dr. Mehta, who brought his proposal to Dr. Adipietro. The pain specialist had been approached by other doctors with similar ideas, but none were as well thought out as Dr. Mehta’s, Dr. Adipietro said. They initially were going to use a consulting group to guide them in the development of the Surgical Center, but ultimately managed the process themselves.
It started with identifying a site that today they now see as perfect, but originally was an aged building just north of the Long Island Rail Road tracks. On the first walk-through they realized it was an old structure. “This was a lot of work,” Dr. Adipietro said as he showed off the sparkling new Surgical Center with amenities few developers might have even proposed.
At the entryway, for example, there are vents that provide warm air, but their installation ensures that the heat doesn’t overwhelm the waiting room since the entire building is climate controlled.
For that and many other features, Dr. Adipietro credits Patricia McGrath at Coastal Home who was involved in every aspect of creating working space that feels more like a home than a hospital.
“I wanted patients to feel they are in someone’s living room, not a hospital,” Dr. Adipietro said.
A quiet waiting room offers calming music, but no television and that, too, is purposeful. In the world of news today, Dr. Mehta didn’t want patients awaiting procedures to be disturbed and even arguing about what they were watching on TV, he said.
The front reception desk has two levels, one low to accommodate a person who might enter in a wheelchair. There’s a private space to interview patients.
The obvious need for a generator to provide power in stormy weather when electrical connections could be lost was no easy step and just one of many construction delays.
The generator couldn’t be rolled in to where it had to be located, but had to be hydraulically lifted over the building.
When a patient enters for a procedure, he or she has a private room in which to change and a locker with a key for the belongings. The patient keeps the key throughout the procedure.
The pre-op and post-op area is large and bright and each patient’s vital signs are monitored. Each area has features such as chairs that convert to stretchers for many of the procedures — the colonoscopies and endoscopies Dr. Mehta performs— to avoid having to move patients from beds to stretchers to operating tables. But there’s also one stretcher specially designed for patients with other problems who may require x-rays. The design enables the patient to be x-rayed through the stretcher.
For procedures where anesthesiology is needed, a qualified physician will be available. All equipment is the state-of-the-art, the doctors said. Neither was willing to cut corners to save a few dollars, they said.
“If I’m doing it, let’s do it right,” Dr. Mehta said. That not only includes a top-level endoscope and other machinery and instruments, but sterilizing equipment to protect against infections.
As for his operating room, Dr. Adipietro describes it as “set up perfectly.”
The two doctors expect to start procedures with patients at the Surgical Center by mid-March. In the meantime, as they complete a few odds and ends, they are seeing patients for intake meetings and scheduling procedures that can wait until they are fully operational.