We are very sorry to announce that, after over five years as Summit County's only internal medicine practice, we stopped seeing patients on June 29, and closed our practice as of July 31, 2012.   Dr. Shiffman's letter to his patients explaining the reasons for this decision is below.  Also below is information on finding another internist, having your records sent to you or to another medical practice, and paying off your account.  We wish you all the best in the future.

Dr. Shiffman's letter to his patients:

May 2, 2012 

To the Patients of Summit Internal Medicine:

Regretfully, I have come to the conclusion that I must close my practice, Summit Internal Medicine, as of June 30, 2012.   I am writing to let all of my patients the reasons for this decision.   I have touched on these reasons in past letters to the Editor.

Maintaining a solo practice unfortunately has become untenable.  First, the actions and mandates of private, for-profit insurance companies are designed to make money for their shareholders and corporate officers, rather than to ensure quality health care for their customers.   Medical care providers must devote a significant amount of resources to following up on claims, fighting with the insurance companies to obtain payment that the insurance companies are contractually required to pay, and responding to repeated, frivolous requests for information and wrongful denials of claims.  These corporations make medical practices do this for two reasons:  to hold on to their money as long as possible, even when it is legally owed to medical practices, and to make it so costly for the medical care provider to fight for payment that the provider gives up rather than spend that money.  For a solo or small practice, this becomes prohibitively expensive. 

Second, Medicare reimbursement rates are absurdly low.  In the last fifteen years, annual rates for primary care have been increased only once to match cost of living increases, and Congress continually announces plans to balance the Medicare budget by substantially cutting provider reimbursement rates.   The prevailing wisdom is that no practice can survive with more than 20% of its patients being on Medicare.  Summit Internal Medicine has a 40% Medicare population, and that is projected to only increase.  Yet, the 20% benchmark would plummet if current Medicare rates are cut.

Third, Medicare is implementing “Accountable Care Organizations,” a program that encourages medical practices to join with hospitals to become multi-specialty medical providers.   Private insurance companies will soon follow suit.  There are three large groups forming in Denver (they will be created as soon as they figure out how to maintain their substantial profit stream), and the wave of the future is for multi-physician, multi-specialty ACOs to move out into the counties by 2014.  There is little in this plan that will benefit rural or mountain communities.

It is already very difficult to run a solo practice.   A physician is paid by insurance companies only for the time actually spent in the exam room with the patient.  That is half the time that I actually spend on behalf of each patient.   There is no reimbursement for the time spent speaking with patients on the telephone, filling out forms for them, speaking with other physicians about patients, reading consultation and test reports, responding to inquiries from physicians, insurance companies, and governmental entities, or recording patient encounters in the patients’ charts.  That means that only half of my time is compensated.   With the changes instituted recently and coming soon from Medicare and private insurance companies, it simply makes it impossible to maintain a solo or small practice.

Finally, I am both a clinician and a teacher.  I have been a faculty member of the University of Colorado Medical School for the last eight years, but have not been able to do any teaching for the last five years because of the press of business in the practice.   I am returning to Baltimore to be a clinician-educator for Johns Hopkins School of Medicine, where I will not have to attend to the business end of the clinical practice, and thus will have the time to teach medical students and residents.

The last five years have been uniquely rewarding and fulfilling for me, and I have very much enjoyed getting to know and taking care of my patients here in Summit County.  This has been a very difficult decision to make, and I know that I will sorely miss my patients.  I thank you for the trust and confidence that you have placed in me, and

I wish you all well in the future.  I hope that you are able to find quality medical care without having to travel too far to do so. 

Sincerely,

Marc S. Shiffman, MD, FACP                                                   

Finding a New Internist:

Unfortunately, there are no other internists in Summit County, and no internists in the mountains or Denver with whom we are sufficiently familiar to make a recommendation.  However, we can make the following suggestions:

Denver Internal Medicine Group
155 South Madison St.
Denver, CO 80209
Phone: (303) 333-5456
Email: info@denverimgroup.com

Dr. Norm Numerof 
Doctors on Call 
142 Beaver Creek Place
Avon, CO 81620
(970) 949-5434

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To request your medical records, please email or mail the following form to us: 

 RECORDS RELEASE FORM 

Please keep in mind that the paper records are now stored, so it may take several days to get the records out.

We will not be able to respond to requests between August 20 and September 20, but will address them upon our return.

Also note that patients with delinquent accounts must pay their balances before we can release their records.

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Billing After We Close:

You will continue to receive bills until your account is paid up.  Your payments should continue to be sent to our current mailing address.   If you wish to pay by credit card, please send an email to the following address:

chambers_dana@yahoo.com

We will contact you to take your credit card information. 

If you have questions about your bill, please email our billing company: 

chambers_dana@yahoo.com