FCS continues growth as nation’s leading privately-owned oncology practice

In an era of much uncertainty in healthcare, Florida Cancer Specialists & Research Institute (FCS) is experiencing the most rapid growth in the company’s nearly 30-year history.

The community-based oncology group recently announced the addition of 12 physicians and seven locations in Pasco, Hernando, Citrus, and Sumter counties, and will also be bringing on several physicians in the Tallahassee area next month."Most of the time, doctors contact us, sometimes at a rate that we can hardly keep up with," said William Harwin, MD, president and managing partner of FCS. "I think it's because we have an amazing model that's very difficult to compete with in community oncology. As a business model, we are very physician-centric; we have no large corporation or private equity partner telling us what to do. FCS is a physician-owned and physician-run practice, and that makes us very different."

Harwin established the group in 1984 in Ft. Myers and has spearheaded the tremendous growth and development of the practice. Now, FCS is the nation's largest privately-owned oncology practice, with 105 physicians and more than 50 clinical sites that serve patients as far north as Gainesville, along the Gulf Coast from Naples to Tampa, and as far east as Central Florida.

Shared Leadership

"Dr. Harwin and the other physicians who serve on the Executive Board of Directors greatly influence our corporate culture," said CEO Brad Prechtl, who joined the company in early 2009. He credits the physician leadership of the group with its ability to attract and retain outstanding doctors and key staff members. "These board members are elected by the physician-partners in each of our regions to represent the interests and concerns of their practices. We don't operate as a top-down hierarchy; we encourage people to speak their minds, make contributions, and constantly communicate with each other."

Prechtl cites the addition in August of seven clinical sites in Central Florida as an example of how the practice develops a new region.

"We look for groups that meet our criteria for exceptional care, and we look for physicians who are the leaders in the community–the best med oncs in that market," he said. "When we enter a new region, we want to make sure that we have significant market share. We want to provide as many locations as possible for our patients to receive world-class care close to home so they don't have to travel long distances. In the greater Orlando area, for instance, we started with seven locations in August and we just opened an additional site in November. We're continuing to increase our footprint in new areas, as well as in markets where we are long-established."

Nationally-Recognized Clinical Trial Program

One of the most unique aspects of the FCS practice is the emphasis on dramatically increasing patient participation in clinical trials. FCS recently received a coveted accolade: the American Society of Clinical Oncology (ASCO) 2011 Clinical Trials Participation Award, which is presented nationally to recognize practices that have established high-quality clinical trial cancer research programs. In association with the Sarah Cannon Research Institute, one of the nation's largest community-based clinical research organizations, FCS offers patients access to more national clinical trials than any other privately-owned, community-based oncology practice in Florida.

FCS recently announced an expansion of research protocols in its clinical trials program, making it one of the few privately-owned groups in the United States to establish a clinical research program of this caliber.

"We're proud to have been recognized in 2011 by the ASCO for our clinical trial program and for initiatives to increase elderly patient and minority patient participation in clinical trials," said Lowell Hart, MD, scientific director of clinical research and director of the company's drug development program. "Both of these groups have been underrepresented in studies of new cancer drugs for many years. We expect to have over 500 cancer patients this year on our trials, and are working hard to increase that number."

Hart pointed out that FCS has also expanded its Drug Development Unit from Ft Myers to include a new unit in Sarasota, with a dedicated research oncologist for clinical trials.

"This gives our patients access to many new agents for cancer treatment that are otherwise not available in their area," he said. "Some of these are the exciting new targeted agents and immunologic agents with greater specificity and, hopefully, fewer side effects that may be the next step beyond chemotherapy for our patients."

Advantages of Scale

Prechtl views the size and diversity of the FCS practice as a great advantage, while also admitting that managing such a large practice has its challenges.

"We want to make sure we have enough mass to leverage our overhead effectively – to allow us to continue to expand and add services and sites accordingly," he said. "One reason we've been so successful is that we're able to take advantage of economies of scale. For example, buying drugs in larger quantities at lower rates allows us to better manage our overhead and reinvest dollars back into practice areas that benefit our patients."

FCS continues to focus on improving services to patients while also providing strategic advantages to physicians and staff.

"We're constantly updating and improving our clinics, or adding new services that benefit both patients and clinical staff," said Prechtl. "Because of our size, we're able to offer many expanded services that you typically won't find in a community-based oncology practice."

For instance, FCS leveraged its size to become more competitive in the ever-changing marketplace and provide greater efficiencies and cost reduction in ancillary services, like its in-house pharmacy, centralized lab services such as flow cytometry and circulating tumor cells, histology, hematopathology, mobile and fixed PET/CT, radiology, and, in some of clinics, radiation oncology, explained Prechtl.

Also, FCS has developed a fully-integrated Electronic Medical Records (EMR) system that allows access for the team of doctors involved in a patient's care, and also for the patients.

"With our web-based system, I can access my records at night from home or on my smartphone anywhere there's an Internet connection," said Harwin. "This asset tremendously impacts patient care immediacy. We also have EMR sharing so that referring physicians can communicate effectively with us, and all our physicians can consult with other members of the care team."

But, Harwin added, "what really makes our EMR so amazing is that much of the innovation came from our own Dr. Mark Rubin; it fits perfectly with the way an oncologist thinks and practices."

Fostering Communication and Connection

Despite large geographic distances between the FCS corporate offices and the majority of the clinical sites, the group stays connected via monthly meetings in each region, email and other targeted communication initiatives between offices and physicians. That level of commitment keeps physicians strongly engaged and connected to the organizational mission, even on weekends.

On a recent Saturday afternoon, Harwin, a competitive biker, was riding by the FCS Flow Cytometry Lab in Ft. Myers when he noticed two cars in the parking lot. He walked in to find Mohammad Abuel-Haija, MD, and Ryan Olson, MD – FCS hematopathologists – hard at work. He snapped a picture with his smartphone and dispatched it to all FCS doctors, reminding them that in-house pathology services can streamline test results for their patients.

"The glue that holds us together and keeps everyone focused on the same goal is our patient-centered approach," said Prechtl. "Everything we do is targeted at reducing stress and optimizing care and cutting-edge treatments to result in better outcomes for our patients. We have to be incredibly efficient and we have to have physicians and staff who are incredibly dedicated to their profession and the needs of their patients. That's the real secret to our success."

TAGS: Florida Cancer Specialists & Research Institute, FCS, Dr. Bill Harwin, Brad Prechtl, Dr. Lowell Hart, Dr. Mohammed Abuel-Haija, Dr. Ryan Olson, Dr. Mark Rubin, American Society of Clinical Oncology 2011 Clinical Trials Participation Award, ASCO, 2011 Clinical Trials Participation Award, FCS Flow Cytometry Lab.

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