As her conflicts with DSI increased, DuPree tells me she considered buying the business but was convinced by her lawyer that she would “have to put on her big-girl pants” and let the hospital close for a time—or else her new entity would be responsible for the old facility’s debt. In the midst of all this, DuPree underwent surgery to correct a colon problem. (“No coincidence that my guts are twisting literally while my guts are twisting emotionally,” she writes in an e-mail.) “It’s been hell,” she tells me on the phone February 3, the night before the clinic is due to close. “Utter hell.” Although her private practice still operates out of a space she’s leasing in the building, her 85 hospital employees are being laid off.
“She was ahead of the curve,” says Greg Wozniak, president and CEO of St. Mary’s, where DuPree’s practice used to be based. “And candidly, our whole industry is evolving to that, to trying to change the model so we’re looking at the whole person.”
She is organizing a group of 20 to 40 doctors, some of them her former colleagues, who would take over ownership of the center, in partnership with a local hospital. And while she has a plan B—to relocate the program within another hospital—what she really wants is to develop a partnership that would enable her to remain in the facility and resume her program there.
One chief of a nonprofit Pennsylvania hospital is strongly considering the idea of going into business with DuPree. “We’d do our whole range of women’s services [in the revived facility],” he says, while asking not to be named because of the ongoing negotiations. “[Her model] is much more of a healing setting . . . What we can give her is the infrastructure and support to [allow her to] be an inspirational leader and surgeon. We can put things there that can give her the [patient] volume, and we can go back to the insurers” to negotiate in-network coverage.
“Places like what she created will win,” the hospital chief tells me. “The reality is that Beth has forced all of us to look at what we do in health care. Everybody wanted her to fail, because we don’t want change. But my team said, ‘There’s good stuff here and we need to look at it.’ ”
Just as DuPree is gathering partners—no mean feat in this economy—it turns out that Washington may also have a say in her plans. Concerned about the issues (ethical and financial, among others) raised by doctors referring patients to companies they own, members of Congress proposed legislation banning physician ownership of hospitals. For now, it’s in limbo. “But what if in six months it rears its ugly head?” she says. And so Dr. DuPree goes to Washington, to lobby Pennsylvania Senator Robert Casey Jr.
While waiting for her turn with the big guy, DuPree goes around introducing herself to aides, practicing her pitch—“First, breast care is not a big moneymaker, which is why there aren’t any other places like this, and yet [physician ownership is] getting a bad rap because of a few bad colleagues!”—and asking if the female aides have had their mammograms. She works the room, batting down objections that boutique shops like hers greedily skim off the most lucrative patients. “We’ve always cared for the indi-gent,” she says. (DuPree estimates that she treats three uninsured patients a month.) A half dozen Casey staffers gather around her. By the time the senator joins them, she’s not just warmed up but breathing fire. “Instead of taking the cream off the top, we’d take the crap too,” she assures him animatedly. “But maybe there’s a better word for crap?’’ he asks, laughing. “Nooo, crap is better,” she answers him.
“If you own a home, you take better care of it—that’s why we need a hybrid model” that allows part ownership by physicians, she says. “I’m willing to listen,” he tells her. “What would you argue?”