Physicians' exit to close infertility clinic at UW
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All four doctors at the University of Washington's influential infertility center, the largest in the Northwest, are leaving to start a private clinic, backed by a fast-growing, national for-profit company.
Their new enterprise, Seattle Reproductive Medicine, will be located in the South Lake Union area in a state-of-the-art facility equipped by their new partner, IntegraMed of Purchase, N.Y., which has committed up to $3.2 million to the effort.
This may be the first time an entire service has left the medical center, causing the Fertility and Endocrine Center to close Sept. 24, UW officials said.
But it's not the first time a university-based fertility clinic has gone private.
Nationally, several in vitro fertilization (IVF) clinics have moved from academic medical centers to private practice in the past few years, said Dr. David Eschenbach, chairman of the UW Department of Obstetrics and Gynecology (OB-GYN), the umbrella department for the fertility center.
"It's very enticing to do IVF, in terms of money," Eschenbach said. "People just find they get monetarily rewarded much better in the private world than in the academic center."
But Dr. Michael Soules, who began the UW's well-regarded in vitro fertilization program in 1984, said bureaucracy and skimpy staff support pushed him and the other three specialists to consider the move.
"It wasn't an easy decision," he said. But the clinic's understaffing, the complex billing arrangements, computer systems "that don't talk to each other," and long waits for appointments were difficult for patients and frustrating for the physicians, he said.
For him and his colleagues, Nancy Klein, Angela Thyer and Paul Lin, what should have been a balance of patient care, research and teaching threatened to tip last year after two doctors left the clinic, he said.
"All we found ourselves doing was full-time clinical practice," Soules said, performing some 400 IVF treatments per year for patients from a five-state area, including those seen at a Bellevue satellite clinic. Support-staff levels were so low, he said, the doctors found themselves overwhelmed with paperwork and other tasks that, in their new practice, would be done by nurses and other medical staff.
The UW clinic's growing success at creating pregnancies — 60 to 70 percent for women under 40 — built the center into the largest IVF provider in the Northwest.
"I'm proud of what we've accomplished," Soules said. But word got around, and appointments grew longer and longer, he said, and patients weren't getting the customer service they or their doctors wanted.
"Our success rates are what did us in."
Contemplating the switch to the for-profit world, he and his colleagues investigated practices around the country, he said.
What they found was that patients were happier and doctors "less stressed" when there was a higher staffing level and a "more efficient practice."
For example, he said, the company plans to support the clinic with five full-time managers who would do the job now done by one 80 percent-time clinic manager at the UW.
Soules said the doctors would own 80 percent of the clinic and have made a five-year commitment to IntegraMed, the largest fertility-services company in the country.
It now has a piece of the action in 25 of the nation's top infertility medical practices, which together account for about 30 percent of the attempts to create a pregnancy through IVF, Soules said.
He said he expected the decision to be good news for patients, who come to the clinic for a variety of reproductive issues.
"There will be more access; they won't have to wait eight to 10 weeks for a new appointment," he said. He said he expects prices to be about the same, or possibly lower, to compete with other IVF programs in the area.
A high staffing level will free the doctors to see more patients, and "do more cycles," fertility lingo for one attempt at an artificially created pregnancy.
The UW clinic does about 400 "cycles" per year, each now costing $9,000 to $10,000. About 80 percent of the billing is paid privately, not by insurance.
Since 1984, the clinic has used IVF to help create more than 1,000 babies, he said. It sees more than 1,200 patients a year for all reproductive issues, which might include difficulties in ovulation or uterine abnormalities that need surgical repair, and has more than 4,000 patients who have been seen in the past two years.
Soules, a nationally recognized expert in reproductive aging and fertility, is a former president of the American Society for Reproductive Medicine. His campaign to inform women that the older they get, the more difficult it will be to get pregnant got national attention, including a Newsweek magazine cover piece in 2001.
The move leaves a number of issues undecided, among them the future of frozen embryos stored at the UW Embryology Laboratory.
Soules said the UW is having "internal discussions" about how to keep them for patients until they're needed, and how to transfer them to Soules' new clinic or another facility chosen by the patients.
Typically, Soules said, 98 percent of embryos are used by patients within the facility where they were originally frozen.
In this case, though, there won't be any doctors to implant them at the UW, where they are now frozen in liquid nitrogen.
Eschenbach, the UW's OB-GYN department chairman, said the department would continue to offer many of the medical services now performed at the clinic, including diagnosis and treatment of menopausal problems, endometriosis, fibroids and other reproductive issues.
Eventually, the UW could offer in vitro fertilization again, but that hasn't been decided, he said.
The UW has notified about 4,000 current patients about the change and set up a special telephone line for patients with questions about the transition: 206-598-7482. Care for patients planning in vitro fertilization cycles before Aug. 15 won't be affected, officials said.
The Fertility and Endocrine Center at UW Medical Center-Roosevelt as well as the fertility services at Eastside Specialty Center in Bellevue will close Sept. 24.
Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com
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