On Sept. 1, about a year after a building fire and subsequent water damage devastated the New Hyde Park office of the Long Island Women's Health Care Group, Dr. Gary Levine, president of the practice, reopened its doors.
"You have to basically start all over again and just rebuild from the ground up," he said of reconnecting with his former base of 2,000 patients, who had gone elsewhere in the year the office was under construction.
Levine learned his love for medicine while in high school at Great Neck South when his uncle, a cardiologist, allowed him to observe while performing cardiac catheterizations at St. Francis Hospital.
Levine went on to Chicago Medical School and, after a residency at Roosevelt Hospital in New York, joined the Long Island Women's practice in 1978. He became president around 2003.
The practice, which started in a small basement office in 1958, has grown to three offices, including ones in Mineola and Syosset, six physicians and a nurse practitioner, all specializing in obstetrics and gynecology.
How are you rebuilding your patient base in New Hyde Park?
We're doing a lot online, getting ourselves back out on Google, letting our current patients know. . . . All the advertising that we can possibly do to let everybody know.
Over the 35 years you've been in practice, what's the biggest game changer you've seen?
Robotic surgery. We're now doing procedures through small incisions that are approximately an inch to an inch and a half. You're talking about a recovery period that is anywhere from hours to days -- as opposed to from weeks to months.
What questions should people be raising in presidential debates regarding women's health care?
I would just want them to make sure that all preventative testing was fully covered [by insurance], whether it be mammograms or sonograms or vaccinations, at the proper age, without having to get preapproval or authorizations.
How are sites like Yelp and social media changing the way medical practices operate?
Years ago, it used to be doctor referrals. And then it became patient-to-patient referral. Then it became "You're in my insurance plan." And now, I'd say, almost 90 percent . . . they're coming with information off the Internet, saying, ''I Googled you. I wanted someone in this area. I wanted someone associated with Winthrop Hospital. I happened to go to your website.''
And insurance has been the big change?
There has obviously been a transition from patients who used to have private insurance -- yesteryear -- to the HMOs. So the private insurance people used to go to whatever doctor they chose for whatever reason. Then the HMOs or the prepaid medical situation came into play, and the patients had to gravitate towards the physicians that participated in that particular plan. So that was a large change in the whole gestalt of medicine.
Has it changed patient numbers?
It's probably accounted for a large increase in patients.
Have the reimbursements changed?
They've diminished tremendously. Probably close to 50 percent. Now you're under contract with the insurance plans. So you have to accept whatever payment they've dictated for that particular procedure.
So you have to be careful with those contracts?
The contracts are basically nonnegotiable. Either you sign up for their plan and you participate as a physician, or you're not able to see that group of patients participating in that particular plan.
Is this forcing private practitioners to become employees of hospitals?
That is correct, because the private practitioner has great difficulty in existing, because the expenses of the private practitioner have continued to increase, yet the reimbursements have continued to decrease. And obviously, you can't run a business with that model. So the private practices are being bought up by various institutions in order for them to survive.
Name: Dr. Gary Levine, president, Long Island Women's Health Care Group
What it does: Women's health care, obstetrics and gynecology, testing, screening and prenatal care
Employees: 26 full time; 10 part time
Revenue: $6 million