Clinical Commitment: Area health care systems invest tens of millions in specialty care clinics

Heather Mosley | SBJ

Skin treatment technology has been installed at the CMH Dermatology Clinic.

Michael Calhoun: CMH Dermatology Clinic fills in-demand specialty service.

Brock Shamel: CoxHealth is investing $1M in renovations to its Bone & Joint Center.

Dr. Brad Wyrsch: Local clinic investment at Mercy is $20M this year.

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Across the region, local health systems have invested heavily in clinics, as CoxHealth, Citizens Memorial Hospital and Mercy Springfield Communities have combined spent over $60 million in the past two years on new clinic construction or upgrades.

In Bolivar, the opening this month of the CMH Dermatology Clinic filled a specialty service the Bolivar-based health system had been without for the past six years.

CMH invested $613,000 to remodel a former employee pharmacy on the Bolivar campus to accommodate the 4,466-square-foot clinic led by manager Nicki Cupp and Dr. Murphy Mastin. Michael Calhoun, the health system’s CEO and executive director, said CMH lacked a dermatologist since 2016 and closed its clinic as a result. 

“That illustrates the physician recruitment difficulties that we have in rural areas bringing physicians on,” Calhoun said, noting CMH hired Mastin when he still was going through clinical training. “Sometimes, it takes several years to get a new physician for that specialty. There’s just a shortage of physicians now and it’s a competitive market.”

Medical specialties, such as dermatology, are expected to experience a shortage ranging from 3,800 to 13,400 physicians, according to 2021 data by the Association of American Medical Colleges.

Calhoun said bringing back the clinic is intended to keep patients in Bolivar rather than forcing them to drive long distances for care. 

“There’s a need for dermatologists across the nation. In our community, it was the No. 1 reason that people left our service area for care,” he said, adding over 1,000 patients last year went from a CMH physician’s office to a dermatologist outside its system. “That is probably an underreported number in terms of the need there is, but it does show you there’s a significant amount of people leaving the area to get dermatology care.”

The new clinic’s areas of service include skin cancer and precancerous growth, dermatopathology, cryosurgery, lesion removal, skin rashes in adults and children, benign and malignant skin lesions, and skin infections.

Revenue for the U.S. dermatology industry in 2022 is projected at $8 billion, up from $7.8 billion in 2021, according to data from research firm IBISWorld. Additionally, the market size is expected to grow 2% this year. 

Accommodating needs
Brock Shamel, vice president of Cox Medical Group, said clinical investment has been a priority in recent years for CoxHealth, which has more than 80 clinics in its 25-county service area.  

“We’ve made some major investments in ‘super clinics,’” he said, referring to a facility with multiple types of care in one place. 

CoxHealth has built super clinics in Springfield, Nixa, Ozark, Republic and Monett in the past two years – an investment of over $40 million, according to past Springfield Business Journal reporting.  

“The patient appreciates this unified offering in itself,” Shamel said. “One, it’s easy to access, and people love it when you build a building that is not in the main hub of your health care. The south campus is an incredible place but it’s obviously hard to navigate sometimes and a little scary. 

“We like the ability to make it more efficient and a frictionless experience for our patients.”

Like CMH, CoxHealth renovated existing space two years ago to accommodate a need for specialty services. The health system consolidated its pediatric specialty services, which previously were spread out at Cox South Hospital and The Turner Center. The June 2020 opening of its $2 million CoxHealth Pediatric Specialty Center was the result, bringing specialty services such as developmental medicine, endocrinology and gastroenterology under one roof. 

Future investments
While Shamel said the super clinics haven’t focused on specialty services, CoxHealth is committed to bringing more of those offerings to patients through smaller clinic projects. 

“We are really trying to understand now where do we invest in the specialty realm, whether it’s expansion of specialty or it’s new buildings,” Shamel said, noting its Bone & Joint Center is expanding its plastic surgery clinic and medical spa. The health system also is relocating the vein center onto its campus at 3555 S. National Ave. from leased space on East Kingsley Street. 

The investment is roughly $1 million, and work is expected to wrap in October, Shamel said, adding the trio of specialty services will occupy an entire 15,000-square-foot floor at the Bone & Joint Center. 

“They are three distinct service offerings,” he said. “But it’s a nice, tied together complement service offering.”

CoxHealth also plans to grow the immunologist team at its Ferrell-Duncan Clinic, Shamel said, adding the health system is doubling its current 5,000 square feet for the allergy program. The expansion project is expected to be complete by year’s end. 

Local clinic investment for Mercy is expected to total around $20 million this year, said Dr. Brad Wyrsch, president of Mercy Clinic Springfield Communities. He said that work includes eight Mercy facilities in the Springfield area in need of renovations, such as the entryway of the Smith Glynn Callaway building on South National Avenue. 

The health provider also is in progress on Mercy Clinic Family Medicine-South Creek, a $3.2 million, 5,100-square-foot primary care building to replace a smaller facility, according to past reporting. 

Wyrsch said Mercy also is in the planning phases to expand specialty services in some of its rural coverage areas, including Aurora, Cassville, Lebanon and Rolla.

“Part of that is a very robust recruitment plan to add providers, especially along our [Interstate] 44 corridor,” he said, adding no hiring numbers are estimated at this time. 

Mercy’s clinical attention in rural areas has received substantial investment in recent years. The health system in 2018 opened a $22.5 million multispecialty clinic in Branson, followed the next year by a $26.9 million facility in Bolivar. 

“Many of those patients were already established with Mercy but were traveling significant distances to see a provider,” Wyrsch said. “The strategies there were to better serve those local communities.”

The primary specialty services in the Branson and Bolivar clinics are orthopedics, cardiology and pain management, he said. The Bolivar location also expects to add some outpatient procedures such as endoscopies and hand surgery within the next three to six months. 

At CMH, Calhoun said the health system plans to hire an ear, nose and throat physician to add another new specialty. In other services, such as cardiology, more employees are needed as the demand for specialists continues, he said.

“A lot of our physicians that are specialists do both general care within that specialty and then they might have a fellowship in a particular area that is their additional niche,” Calhoun said, noting some orthopedic surgeons at CMH work in general orthopedics in addition to specializing in spinal care. “It’s kind of necessary that it’s that way in a rural setting. There’s just not an abundance of specialists, so they’ve got to be able to have a broader scope.”