The current health-care environment is creating many new challenges
for physicians, and addressing these challenges has led to new
ideas in office practice management.

To meet the managed care challenge, my own medical oncology practice,
the Metropolitan Oncology Medical Group, Los Angeles, has formed
an alliance with a hospital-based radiotherapist, Armand Bouzaglou,
MD, to develop an outpatient facility utilizing a concept we call
"space sharing."

Our medical oncology group has leased office space within a 7,500
square foot suite owned by St. Vincent Medical Center, Los Angeles.
Roughly one third of the space is dedicated to a hospital-based,
outpatient radiation therapy department, which is headed by Dr.
Bouzaglou.

We have signed an exclusive contract with Dr. Bouzaglou to provide
radiotherapy professional services for our patients. His department
is staffed by St. Vincent Medical Center, with which I am also
affiliated.

The medical oncology group's staff, work areas, infusion room,
and inventory are completely independent of the hospital space.
However, the two practices share a common waiting room, entryway,
employee lunch room, patient library, and conference room. Use
of the complex's seven examination rooms is often "shared"
on an as-needed basis.

Overall, we are trying to provide a full service outpatient facility
in a community office setting. As much as possible, we offer comparable
services to our managed care and our fee-for-service patients.

The result of this marriage is that all of the space is utilized
more efficiently at a tremendous cost savings to both specialties.
It has also fostered a collegial atmosphere. The large conference
area is open for discussions with patients, family, involved treatment
specialists, and the primary care physician.