Children’s of Alabama strengthens pediatric primary care

By: Sandra B. Thurmond, FACHE, CMPE, vice president for Primary Care Services at Children’s of Alabama.

Children’s of Alabama helps support doctors who provide primary care for children in numerous ways. Many of these efforts relate to our medical residency programs and our wonderful on-site medical services, but some help doctors manage their business and time. Here’s a short primer on the business side of these support services.
We approach this challenge from many perspectives. Children’s owns and manages 13 pediatric practices that provide care for children. In addition, we offer services to medical practices that we don’t own. That includes after-hours relief for pediatricians via telephone triage nurses, management support, assistance with physician recruiting and purchasing contracts that provide discounts on vaccines and office supplies.

Our owned practices operate under an entity called Pediatric Practice Solutions, or PPS, which was started in 1995. At that time, Children’s was approached by local pediatricians who were interested in a pediatric-specific business partner. We entered the primary care market not to make money or to compete with established practices, but to build and improve our relationships with the doctors who care for kids.

Doctors and staff in our practices are employees of Children’s of Alabama. We established our first practice, Pell City Pediatrics, in 1995. In 1996, we acquired Pediatrics East Roebuck, which later relocated to Trussville; Physicians to Children in Montgomery; and Greenvale Pediatrics in Hoover and Alabaster. In 1997, we added Mayfair Medical Group, Vestavia Pediatrics, Pediatrics East Deerfoot and Over the Mountain Pediatrics. In 1999, we added Greenvale Pediatrics Brook Highland and Midtown Pediatrics. We acquired Pediatrics West Bessemer in 2001. Our newest primary care practice, Pediatrics West McAdory, opened in 2015.

So, what do we bring to these practices besides a medical connection to the state’s leading pediatric hospital? First, we don’t drain money from them, nor do we funnel money into them. They support themselves, and the doctors working within the practices have a large degree of autonomy. We do provide support services like human resources and payroll that are fairly inexpensive for Children’s of Alabama due to economies of scale.

A valuable service we offer is telephone triage nurses who handle after hours calls to pediatric offices. We established this service in the mid-1990s to take a huge burden off pediatric primary care doctors. When we first introduced after-hours telephone triage, pediatricians flocked to the service. Some said that it allowed them to stay in practice years longer than anticipated because it relieved the burden of being on call 24/7 while giving them peace of mind that their patients were being cared for properly. At present, Telephone Triage provides service to 80 pediatric primary care practices (representing 326 physicians, 55 CRNPs and 3 PAs) plus three pediatric specialty clinics and one county health department. Volume was almost 79,000 calls last year.

We also offer pediatricians and those other doctors who care for kids inside and outside of our system access to contracts we have negotiated for children’s vaccines. Essentially, it allows doctors in small practices to purchase these vaccines at prices discounted like large-volume purchases. These same doctors can also purchase office and medical supplies this way through our contracted pricing.

Being associated with a large teaching program, we are familiar with excellent physician candidates looking for jobs all around the state. We can assist with physician recruitment, and we share candidate names with any practices we know to be looking for physicians. In addition, we provide business consulting services. These services aren’t free, but again, the pricing is based upon our philosophy of strengthening the entire pediatric care system, not just Children’s of Alabama.

Having a strong primary care presence is viewed positively by our credit rating agencies, and with the shift toward outpatient care and a focus on wellness and population health management, Children’s must be positioned to provide the correct treatment in the correct setting. And even though you don’t see us around the main hospital campus, PPS is proud to be a part of Children’s of Alabama and its work to heal and keep well the children of Alabama.


Sandra B. Thurmond, FACHE, CMPE, is vice president for Primary Care Services at Children’s of Alabama. She manages the operation and development of Pediatric Practice Solutions, the hospital’s primary care network, and she is responsible for maintaining and improving relationships with pediatricians throughout the state.