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Managed Care Partners - A Collaborative, Community Approach to Breast Cancer Care

Managed Care Partners Summer 2013

A Collaborative, Community Approach to Breast Cancer Care

Date: July 1, 2013


In tandem with community-based physicians, Lisa Jacobs hopes to improve the level of care that’s available to patients at Howard County General Hospital’s new breast center.
In tandem with community-based physicians, Lisa Jacobs hopes to improve the level of care that’s available to patients at Howard County General Hospital’s new breast center.

When surgeon Lisa Jacobs became the first Johns Hopkins faculty member to attend the Howard County General Hospital Breast Tumor Board, she entered a domain that for the past 10 years was composed mostly of private-practice specialists. As head of the hospital’s newly created breast center, she also began doing operations that previously had been performed by the local general surgical group.

The situation was new to her and new for many of the private physicians in Howard County. 

In addition to giving patients one-stop care that includes screening mammography, imaging, biopsy and diagnosis and treatments, the breast center offers the opportunity for Johns Hopkins to work with the community physicians who are the backbone of medical services delivered at the county’s only community hospital.

One of Jacobs’ main priorities became convincing these private-practice physicians that clinical care at the breast center would be a collaborative effort between them and the academic physicians of Johns Hopkins Medicine.

“I realize that I might be perceived as a competitor,” Jacobs acknowledged. So she spent a lot of time meeting with physician groups who practice at Howard County General and engaging with the oncology specialists and private practice surgeons regularly through the Tumor Board. “By emphasizing that together we’re improving the level of patient care,” she says, “I hope that the breast center will continue being well-received.”

Jacobs’ effort mirrors the mission of the Office of Johns Hopkins Physicians, which is to strategically integrate the school of medicine’s full-time and part-time clinical faculty, Johns Hopkins Community Physicians, and in a voluntary way, the private-practice physicians practicing at Johns Hopkins’ three community hospitals.

Bill Baumgartner, Johns Hopkins Medicine senior vice president and vice dean for clinical affairs, explains that the office will be looking to provide specialized services or programs that the community hospitals don’t have. “It’s a delicate balance,” he says, “between filling a need in a community and not becoming competitive with the private physicians there.”

Julie Freischlag, director of the Department of Surgery at Johns Hopkins, says that instead of going to a hospital or out into the community and saying that the department is  going to set up a breast cancer surgery practice or a cardiac surgery practice, the department prefers for a hospital to come to them and say that it has need for such services.

The leadership at Howard County General Hospital asked the department to set up the breast center at the hospital. Freischlag and John Hundt, administrator of surgery, evaluated the situation and recommended that Jacobs create the center. The Department of Surgery has also hired a breast surgeon to work at Sibley Memorial Hospital in Washington, D.C., and Johns Hopkins Bayview Medical Center in Baltimore. 

Jacobs says her efforts at reaching out to private practice physicians seem to be paying off: “I think they’re generally supportive. Every physician out here wants what is best for patients.” 

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