Provider Spotlight

We ask Dr. H. Jay Wisnicki, an ophthalmologist in MSHP’s CIN, about running two distinct practices: one in Union Square, where his staff sees nearly 40,000 visits per year and works closely with New York Eye and Ear Infirmary of Mount Sinai, as well as the recently-opened Article 28 facility in East Harlem that takes advantage of technology to experiment with new staffing models. Regardless of location, Dr. Wisnicki and his staff are committed to providing care to “every type of New Yorker” regardless of insurance (or lack thereof), background, and ophthalmologic problem.

Could you share your background and journey to opening now two ophthalmology practices here in NYC?

I was born at Mount Sinai, did my residency there, and worked full time at Beth Israel for most of my career. In 2009-10, we privatized our department and transitioned to a private practice where we saw clinic, Medicaid, and privately insured patients. I found space near Beth Israel and we have almost 40,000 visits a year there. It’s a facility for the purpose of seeing all patients in one space: every socioeconomic background, payer mix, and ophthalmologic problem.

Our downtown practice has been very successful and works closely with New York Eye and Ear Infirmary of Mount Sinai. Mount Sinai identified a need for ophthalmology services near the main hospital and approached me about opening a practice here. Because the Harlem practice is a New York State Certified Diagnostic & Treatment Center, we had to fill out a long, 349-page application. During that process, we found out that we’re the only ophthalmologists in the zip code. After 96^th street it just stops. Addressing this need resonated with my past – I’ve done mission work all over the world but I don’t need a passport to come to Harlem.

How would you describe the culture of your practice? What sets it apart from others?

It’s a very academic practice for a private practice and we have some resident rotations. There’s a trend in separating faculty from resident practice but I purposely built my practice with a contrary culture to that. This mentality was something I brought with me from my time at Beth Israel where everyone practiced in the same place. I would challenge anyone who doesn’t do this to ask themselves what’s the core mission? To take care of people. Take care of everybody.

You see patients from every payer-mix. Has this been a challenge?

If you talk to ophthalmologists and say you see Medicaid patients they think you don’t get paid, that you’re giving away care, but that’s not the case and financially it’s not a big deal. My doctors are compensated similar to an RVU formula: it’s independent of payer-mix; productivity-based but not based on payer dollars. That’s what I worry about as the owner.

We see patients on sliding scales and billionaires in the same place, with the same doctors, and the same everything, and people don’t mind it. I was indoctrinated with the “one class care” mentality early in my hospital career. The clinic feel happens because of congestion in the office – it’s more about how many people are waiting at a time than who is there.

We understand you’re experimenting with an innovative staffing model at your Harlem location. How does it work and how well has it worked so far?

All the support staff have equal training and skill and are responsible for all functions. Instead of traditional check-ins, they start medical intake right away which saves time for patients. A lot of the equipment we use is automated so we can quickly train staff with less experience how to do this, and you notice right when you walk in there’s a lot of technology before you even bring the patients back.  We don’t do this downtown yet because there we have a more traditional model. We’ve had a lot of positive feedback so far but we’ll have to see how well it works with a larger volume of patients.

We know interoperability is important to you and you adopted an EMR called athenahealth. How did you decide which EMR and how has it worked out for you?

In 2016, I started looking for a new practice management system and did a lot of research before narrowing down the options to 3 semi-finalists based on demos and reference checks. I ended up choosing athenahealth after visiting their headquarters, meeting with people there, and seeing what it was all about. The choice of a practice management system is the lifeblood of a practice. So far I’ve been thrilled using it – they have a co-sourcing arrangement where they do some work and we do some work, they’re responsive to customers, lots of doctors use the same system, and it works great. I’m always pushing the envelope with them and I’m not shy with my feedback for them. They have a commitment to the future and keeping up with things, plus my senior staff liked it, which was important to me – they use it much more than I do.

What’s next for you and your practices?

I’m focused on developing the facilities we have. I want to fill the centers we have here with patients who need us. We work to make sure patients in the Harlem area are aware of us – marketing is a part of health care. What’s the point of doing all of this if you have no patients? We reach out to community providers, other healthcare organizations, non-healthcare community centers. Referrals are huge.

After that, I look forward to being involved in the community, with patients, professionals, and clinicians in the area. Relationship building has been part of my philosophy from early on. I learned it somewhere along the way and I think that’s part of the human condition to maintain relationships and address needs, health or otherwise.

Any words of advice for providers on a similar path?

Go for the long run and don’t do shortcuts. Think of what’s going to help others in the next 2 months, 6 months, over the years. It’s not just about you.

If you are interested in being featured in the MSHP Provider Spotlight Series, please contact Tiffany Cheng at Tiffany.Cheng@mountsinai.org.

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