MEDICINE WEB SITE Disclaimer Content Australian
The many extracts on these pages are from copyright material. They are owned by the reference given or its owner. They are reproduced here for educational purposes and to stimulate public debate about the provision of health and aged care. I consider this to be "fair use" in the common interest. They should not be reproduced for commercial purposes. The material is selective and I have not included denials and explanations. I am not claiming that the allegations are true. The intention is to show the general thrust of corporate practices as well as the nature and extent of any allegations made.
This web page examines the background, and the story of the General Practice corporation Foundation Healthcare as it listed amidst market enthusiasm in 2000 and then progressively crumbled. It describes its merger with LifeCare to become IPN. The page describes its links to Sonic Healthcare and the way Sonic kept it afloat and finally acquired it in 2005.
Independent Practitioner Network (IPN)
LINKS CORPORATE MEDICINE WEB SITE
A separate web pages lists Foundation's story chronologically year by year
West Australia seems to be the Australian corporate "wild west" with a history of government involvement in business and of shonky corporations run by eccentric, closed minded entrepreneurs. Like so many of the health care entrepreneurs in the USA they seem to be supremely confident, and very persuasive. People become excited by their business models and join them in looking past the inconsistencies in their strongly put arguments. They enjoy enormous success then all too often come unstuck. There have been a series of debacles in Western Australia and some of the perpetrators ended in prison. We should be very wary when they turn their attention to health care.
Foundation Healthcare has a hidden history for misleading the marketplace. It is the reincarnation of two failed companies Giltnet and Formulab Neuronetics. Giltnet was renamed Formulab in late 1995. It enjoyed meteoric market success due to the marketing skills of the self styled genius Anthony Richter. He claimed to have built the next generation artificial intelligence computer.
- - - so far, their innovation -called Richter Paradigm Technology - has not impressed pundits; it purports to be a parallel processing machine capable of reasoning
Richter riches fall $200m. The West Australian December 6, 1996
YOU may recall the mighty Formulab, a 90s bolter from the West which triumphantly purported to have come up with the artificial intelligence computer.
That's the computer which has feelings, can empathise with you, talk footy, provide advice and so forth.
As it sounded like such a good idea at the time the stock price went stratospheric before crashing back to earth and inflicting much pain when the market worked out it was all a ruse.
Does not compute The Australian March 19, 2002 (comparing Foundations later financial collapse)
Large sums were invested in Formulab by the market giving the company a massive capital reserve. Within a year the emptiness of these claims were exposed by Australian academics. A US demonstration failed to impress. In spite of this the company dragged on using up the capital it had raised for another 2 years. It entered voluntary liquidation in April 1999.
The potential economic benefits for health care corporations of a referral base of compliant General Practitioners became apparent at the end of the 1990's. The West Australian millionaire Michael Boyd and his pathology company Sonic Healthcare went down a slightly different path to their competitors. This was largely due to its MD, Dr. Colin Goldschmidt. He did not want to buy GP practices.
Boyd instead established a group of interlinked companies which worked cooperatively. Boyd and his business interests had large share holdings in each and board appointees were shared. In addition to Sonic and Foundation Boyd established LifeCare which provided paramedical and dental services.
This strategy pigeon holed the risks while preserving the advantages of vertical integration. One company could take all the risks without upsetting all the shareholders. Boyd's other companies Sonic and LifeCare would be the primary beneficiaries of Boyd's strategy because they would get the lucrative referrals.
At the same time the holdings by other linked companies and Boyd's large holding in Foundation would shield the important referring group from unwelcome takeovers. No hostile bidder could secure enough shares from disinterested investors to force a compulsory takeover.
Whether this strategy simply eventuated or whether it was part of a grand plan is not clear. If shifting the risks to one company and the profits to the others was part of a plan then shareholders were not aware of this. It is difficult to believe that Boyd could not do the sums.
Foundation's strategy involves imposing standardised management, accounting and practice systems on the businesses it acquires, while contracting doctors and relocating them to new medical centres.
That strategy involves acquiring up to 72 small GP practices in WA (about 20 per cent of the market), which would be amalgamated into at least 15 medical centres in the Perth metropolitan region.
Foundation Relists In The Face Of Rival -- Australian Financial Review May 4, 2000
General practice, on its own, is not where the big money is made in medicine. The average Medicare payment to radiologists in 1999-2000 was $650,000 and the average to pathologists was more than $600,000, however the average to general practitioners (including those working part time and full time) was about $110,000. A bulk-billing general practitioner wanting to generate an after-expenses but pre-tax income of $130,000 (assuming the cost of running the business is taking 35% of revenue) needs to conduct 37 standard consultations a day, five days a week, 48 weeks a year. In other words, one patient every 11 minutes, seven hours a day, with public holidays and a couple of weeks off over Christmas.
Corporate Medicine, Business Review Weekly 29 September 2000
Foundation is born
Foundation Healthcare was established by buying the shell of the failed company Formulab Neuronetics. It was recapitalised through an investment by Boyd and his associates together with a float on the market. Although Foundation bought two pathology businesses in West Australia and some company reports refer to hospitals its primary focus was General Practice. It later sold its pathology holdings to Sonic and divested its properties.
Foundation was one of the first to start buying general practices in Western Australia. It was soon part of a frantic scramble by a host of money hungry groups to buy up GP's across Australia and so obtain a dominant share of GP's referrals. Boyd, like Mayne's Smedley had a reputation as a man with the model for business success.
Within 4 months Foundation's 10 cent shares were trading at $1. Foundation was extraordinarily successful, much more so than its competitors. The more it bought the more its share price rose and the more money the market provided through floats. Analysts were ecstatic and the company's unproven model was widely praised.
Foundation offered GP's inflated prices for their medical practices. Instead of paying cash Foundation used their inflated shares as part of the purchase package. Enthusiastic support from the market and from banks allowed it to expand rapidly into Victoria, NSW, Queensland and South Australia. Within little more than a year it controlled the practices of over 1000 GP's, 6% of Australian General Practice compared with less than 1% by most major competitors. It share price reached $2.75.
Its business model revolves around assuming the peripheral functions of medical provision property, administration and human resources from the doctors in return for management fees.
Under such an arrangement, the medical centres are owned by a corporation rather than a partnership of doctors. In turn, GPs forfeit their partnership rights in return for shares and an employment contract.
Foundation's Pace Of Growth A Tonic For Investors Australian Financial Review November 28, 2000
The model Foundation centre is a one-stop shop of about 1500 sq m with 10 to 12 doctors' rooms and specialist services like X-ray, pathology, physiotherapy and a chemist shop.
Healthcare group moves into St Paul's Terrace Courier Mail June 15, 2001
Through a strategic 8 per cent shareholding in Foundation Healthcare (see page 51), Sonic has indirect vertical integration. Foundation provides a link to more than 1000 general practitioners and it has priority referral for pathology and radiology work from that huge network.
Diagnostics Providers Continue To Expand: Shares Magazine 1 September 2001
Foundation established medical centres and relocated groups of GP's into them. Sonic's pathology and Diagnostic Services, and LifeCare's paramedical services were in the same buildings. A deal was struck with Sigma for the provision of pharmacy services in these centres. Boyd successfully set up the One Stop vertically integrated system which Mayne and Barry Catchlove had advocated in 1997 but never implemented. Hospitals were no longer as profitable and were not a significant part of the alliance.
The sharemarket is claimed to be about hard economic reality but even a cursory examination of Foundations model reveals it to be another example of illusion, gullibility and perhaps as Malouf indicated in his Boyer lectures "an eye for the main chance and the weakness of others". As I have indicated elsewhere the GP's were vulnerable and could readily be induced to break away from the united stance of their colleagues by entering into contracts with corporate interests.
Foundation's profit was to come from the income made by GP's, not from their referrals. GP's were already underpaid, struggling to make a living and working long hours. They were unlikely to generate any more money - not unless they could be persuaded to abandon their clinical responsibilities to patients and embrace ultra fast medicine. Foundation was promising them relief, not another sweatshop.
It requires economic obfuscation to overcome the common sense analysis that Foundation could never generate the sort of profit from GP services which management suggested and which shareholders expected it to - unless of course they could exploit the vulnerability of patients. There are limits to restructuring and administrative efficiency gains. What is alarming is the way market analysts, the banks and doctors themselves all swallowed this nonsense.
At the very best the company could only hope to make a very modest profit and keep going. One must ask whether Foundation's founders were as deluded by their own model as the marketplace. Alternately were they shrewd entrepreneurs exploiting the gullibility of doctors and shareholders in order to secure market dominance for their other interests. There is no evidence either way. Certainly they did nothing illegal. The common sense analysis simply reaffirms the axiom "buyer beware" and highlights once again the unsuitability of the share market as a vehicle for the provision of health care, a community service based on trust.
The bubble bursts
The bubble lasted for 18 months but shortly before it burst Foundation sold its pathology businesses to Sonic Healthcare. Sonic was the pathology business in the alliance and pathology is profitable.
By July 2001 a US Warburg analyst had got around to actually analysing Foundation's business model and comparing the actual profits and the likely future profits with the large capital expenditure. It was followed soon after by Deutshe Bank which promptly jettisoned its shares. In September the Deutsche Bank indicated that at the current level of funding and cash burn Foundation would go under in 3 months. The share price fell rapidly and by the end of the year had reached 18 cents although it then rallied slightly. At the same time Sonic Healthcare's shares soared up 40%.
Australia's biggest GP corporation, Foundation HealthCare, is facing a falling share price, a bitter legal dispute with former partners, and highly negative analysts' reports suggesting its business plan and management approach are unproven.
Deterioration and litigation
The court papers paint a picture of a medical empire that has been racked by disputes over alleged shortfalls in projected revenues, unpaid rents on some medical centres, alleged breaches of contract and the possibility of multimillion-dollar claims for damages.
Foundation's Plan Crumbling Australian Financial Review August 3, 2001
Today's article in the Australian Financial Review incorrectly represents that we are in dispute with almost 200 doctors that joined Foundation from Medihelp. As public records show, Foundation HealthCare is not in dispute with any of its practising doctors and the Medihelp Acquisition has been successfully completed and is not at risk.
Stock Exchange Announcement 3 Aug 2001
NB. Update in 2006
As a footnote, FNC announced in July that the cross-litigation with Medihelp, a vendor to FNC of medical centres in November 2000, had been settled on mutually acceptable terms. Our view that the outcome of the litigation would not be material to FNC was behind our removal of a Higher-Risk rating in SCG 289.
LIFECARE HEALTH LTD (LCH) $0.10 Smaller Companies Guide September 18, 2002
In my view it is most unlikely that Foundation Healthcare will go under. It is too important for Boyd, for Sonic and for LifeCare. All benefit from the flow on referrals. If the earlier business assessments are correct then the success of the other companies depends on the referrals from this general practice base. It is not a palatable takeover target for anyone except Sonic. Companies like Mayne Nickless which are interested cannot get full control without Sonic and Boyd's approval. This is unlikely to be forthcoming.
In my view Sonic and Boyd will continue to prop up the company and it will continue to operate and make a very modest profit. Shareholders whose investments have been decimated will get a small return on their remaining holdings.
The $179.4 million drop in market cap over that time reflects the absence of faith in a business model that has used its hitherto inflated equity to snap up GPs.
Lack of faith in the model
The Foundation model is based on a rising share price. When that collapses, the question is: Is the model broken?','' said one analyst. Many investors think it is.
Foundation shakes: Australian Financial Review September 12, 2001
Doctors who accepted shares in lieu of cash have been burned. I have no sympathy for them. The pitfalls of corporate medicine have been widely publicised and the evidence of dysfunction is readily available to those prepared to look. In my view they have betrayed the trust of their patients by becoming employees of a group with a prime commercial interest.
In contrast we should be very concerned for patients and the care they will receive. The shareholders who followed the advice of analysts deserve our sympathy. The analysts and financial advisers should be held accountable.
To reduce costs the company will rationalise and restructure the services it provides. It will attempt to squeeze more money out of the way GP's practice.
The focus on cost reduction will now be subordinated by a drive for profitable revenue growth, as we develop and implement plans to maximise the value and scalability of our patient interactions.
Stock Exchange Announcement 17 March 2002
What are the options? US corporations like Columbia/HCA and the aged chair chains have pilloried Medicare by looking at the way profits can be increased. They have exploited the inexactitude in clearly defining and policing the interpretation of Medicare item numbers. This is not illegal if it is done carefully. Some of the fraud actions in the USA result from practices like this. Medicare funding has been restructured to address this problem and no longer pays per item of service.
It is not difficult to predict that Foundation will follow the US health care corporations and use financial incentives in order to increase GP's financial productivity. This is the markets solution to productivity problems. Incentivisation has been one of the prime problems in the USA. It lay at the heart of the misuse of patients in the 1980's psychiatric scandal, the Columbia/HCA fraud debacle, and the aged care scandal, both in the 1990's.
Incentivisation is the mechanism by which managed care keeps medical costs down and the reason why it is detrimental for care. Managed care corporations are as a consequence the subject of large numbers of class actions and massive punitive damages for denial of necessary care (e.g.. US $120 million in one case). One doctor working for a managed care company describes how she was praised and rewarded for denying care which would have saved a young persons life. One need only look at the US experience to understand what the outcome of incentivising medical care is likely to be.
Foundations shares have stabilised at just over 40 cents, assets have been sold and the company is concentrating on increasing profits from its services. It has initiated a program of incentivisation for its doctors. They are looking at Medicare item numbers.
Having largely completed the necessary phase of corporate restructuring, we are now focusing on operational improvement and are beginning to drive medical centre margin improvement
Encouraging GP's to optimise profitability
Medical centres and Doctors are being resourced to support optimisation of revenue through participation in Practice Incentive Payments (PIP), Service Incentive Payments (SIP) and use of Enhanced Primary Care (EPC) item numbers.
Stock Exchange Announcement 14 March 2002
Regardless of what happens to Foundation in the future the doctors are now practising in their new offices adjacent to Sonic and LifeCare services. Sonic and LifeCare will continue to benefit from their referrals. The model is in place.
1. The gullibility and instability of the marketplace, the aggressiveness of the entrepreneurs, and the number of people who have been burned. Is this a suitable environment in which to provide care to trusting and often vulnerable people? The GP's are the doctors that citizens know best. They turn to their trusted GP for help when they are unsure.
2. The purchase of practices using shares. This strategy was used by Columbia/HCA to secure the loyalty and support of their doctors in the USA. The doctors are bound to the corporation which they now partly own. They benefit financially when they refer to the company's services. Columbia was forced to abandon this practice. In the case of Foundation it will be LifeCare and Sonic investors and not the doctors who benefit but the sense of loyalty as a shareholder remains.
3. By using overpriced shares in lieu of cash it is possible for some companies to pay much more for practices than other more responsible corporations.
4. Doctors now find themselves working for a company which is under strong pressure. As responsible employees they will feel under pressure to make do with less, work longer hours, and see more patients in the time available. Will care suffer?
5. By their extravagant purchasing Foundation, Sonic and LifeCare have secured a dominant market share in the GP referral marketplace. Foundations shareholders have not benefited.
6. Sonic and Boyd have done nothing obviously illegal and their enthusiasm for the model of care may have swamped their judgment. The whole episode nevertheless leaves an unpleasant taste and to conspiracy theorists might suggest that Foundations shareholder's and doctors have been taken for a ride in order to benefit core investors in Sonic and LifeCare. The Canadian critic John Ralston Saul has suggested that there is no need for conspiracies when criticising corporations. These people actually mean what they say and think this way. He is probably right! Perhaps Boyd did believe that his model would work.
profitability in 2002
Foundation in 2002 was struggling to find doctors and was forced to close some of its GP practices and sold others. To raise capital it sold properties and hospitals then leased them back.
AN ACUTE shortage of doctors has been blamed for the closure of a Greenvale practice. Greenvale Medical Centre will shut its doors on August 2.
Looking for cash
Practice owner Foundation HealthCare would not comment on the closure last week. But a sign posted on the door of the clinic said: "This is the unfortunate result of the acute shortage of doctors available to work in the community".
The dental service at the centre will remain open while its owner negotiates to stay on.
The medical centre itself includes doctor, physio, pathology and osteopath services.
Medicos go missing Hume Moreland Observer July 10, 2002
Listed medical company Foundation Healthcare has continued its national sale and leaseback program, disposing of one of Melbourne's oldest private hospitals for $4.55 million.
Listed medical company Foundation Healthcare has continued its national sale and leaseback program, disposing of one of Melbourne's oldest private hospitals for $4.55 million.
Foundation sells hospital. Australian Financial Review July 30 2002
Foundation Healthcare, - - - - - the company would certainly have lost money again. It lost $28 million in 2000-01.
A sick business. Business Review Weekly October 3, 2002
Foundation Healthcare is undergoing a sale and lease-back of its 14 medical centres in Perth, Western Australia.
Foundation Healthcare's sale of Cottesloe Medical Centre will top a busy year. The West Australian (ABIX Abstracts) October 9, 2002
LifeCare and Foundation
merger - becoming IPN
Foundation's merger with LifeCare in June 2002 was a reverse acquisition with the merged company assuming the name LifeCare. In November it changed its name to Independent Practitioner Network (IPN). The company's claims to the total medical independence of its doctors must be set against their intention to use incentives, presumably to encourage doctors to modify their clinical practices and their charging to increase profitability. The press reports suggests very considerable influence. How does this differ in effect from a straight forward kickback and what are the consequences for medical care?
Mr Boyd said yesterday the proposed union of Foundation, Australia's biggest aggregator of general practitioners, and the country's biggest physiotherapy group, LifeCare, made strategic sense, on top of delivering synergy savings.
Foundation has been unable to deliver on its own forecasts that propelled its share price to $2.74 18months ago. The stock closed at 37cents yesterday,
Boyd Determined To Build Solid Health Foundation, Australian Financial Review May 14, 2002
Macquarie Equities said yesterday the merger between health-care group LifeCare and general practice firm Foundation could force Sonic to write down the value of its investment in Foundation by up to $20 million
Writedown Fears Send Sonic Into Casualty, Australian Financial Review May 15, 2002
While the wisdom of his Sydney move is not being questioned, the growth strategies are yet to deliver financial rewards to shareholders. Foundation is in the throes of merging with the smaller LifeCare.
For Business, The Sun Shines Brighter In East, Australian Financial Review June 13, 2002
LCH today is the product of the merger between the old LifeCare, a provider of services to physiotherapists, and Foundation HealthCare (FNC), the GP consolidator and provider of services to GPs. We have covered FNC since SCG 279.
The merger was effectively a reverse takeover, implemented by scheme of arrangement, by LCH of FNC. FNC shareholders received 3.8 LCH shares for every FNC share but gained control of 86% of the combined entity. FNC MD Ralph Shreeve became MD of the new LCH. The merger was effective on August 20.
Aims to be the leading provider of services and infrastructure to independent clinicians
This means providing to clinicians an operating structure, incentive scheme, premises, support staff and business guidance.
GPs are encouraged to increase their incomes by switching from bulk billing to private billing (charging above the Medicare schedule fee), doing more procedures, and doing more value-added work, e.g.. pre-employment medicals. Whereas many GPs perceive they cannot gross more than $120,000 pa, 10% of LCH's GPs gross more than $200,000 and one earns $500,000. LCH charges an average of 45% of a GP's gross billings.
Attracts more GPs by offering a doctor-friendly environment oriented towards helping GPs increase their incomes;
. Lifts private billing from 20% of consultations to 60%;
LIFECARE HEALTH LTD (LCH) $0.10 Smaller Companies Guide September 18, 2002
Sonic assisted by increasing its holding from 10% to 20%. In turn IPN entered into a cooperative agreement with Sonic which gave it the right to pathology and radiology services in Foundations Medical Centre's. They also embarked on joint software ventures for medical computing. Seventy-five percent of IPN's doctor's referrals went to Sonic and these measures effectively locked IPN into a subsidiary referral source for Sonic - one whose losses did not appear on Sonic's books. IPN was now very much a part of Sonic. The relationships between Sonic, Foundation, LifeCare and IPN are described on the Sonic page as is IPN's deteriorating financial position. This deterioration may have been in part as a consequence of the business advice and high fees which its doctors were advised to charge.
After exercising options in November and buying Mr Boyd's 61.4 million shares in February, Sonic Healthcare now has an 18.5 per cent stake in IPN that should ward off predators such as Mayne Group and secure the relationship that gives it first rights on establishing pathology centres in IPN medical clinics.
Sonic's investment and the deal
"They [Sonic Healthcare] are a pathology partner. It's very important to us," said Mr Shreeve.
IPN completes cycle of change Australian Financial Review April 2, 2003
Sonic has a 19.63 per cent stake in IPN. It also has a strategic relationship with the company, allowing it to promote its pathology services to IPN's 1000-strong clinicians working at more than 150 medical centres.
Sonic Trumps Rival With$43m Bid For Rest Of IPN Australian Financial Review June 23, 2004
IPN generates revenue from doctors' fees and by leasing space in the centres to tenants such as pharmacies. IPN's centres mostly bill patients directly, in the hope that higher fees will increase revenue enough to offset any loss of bulk-billed patients. Dr. Bateman has put the patient losses in the past year in some IPN centres at as much as 50 per cent.
Surgeries network facing big write-offs The Sydney Morning Herald July 12, 2004
But a combination of flawed strategy, high expenses (including management - chief executive Ralph Shreeve was paid $489,000 last year) and management problems, has meant that neither Foundation nor IPN has ever reported a profit. In the year to June 30, 2003, IPN reported an operating loss of $13 million, which blew out to $36 million after extraordinaries.
The reason for Sonic Health's long-term support of Foundation/IPN is simple. Although doctors in the IPN medical centres are not obliged to refer their patients to Sonic's pathology or radiology practices, most of them do.
Health care Business Review Weekly July 29, 2004
This deal grants Sonic the right to require IPN to lease part of the premises of any medical centre owned or managed by IPN to Sonic for the purpose of installing a Sonic pathology collection centre or diagnostic imaging facility.
Sonic's higher bid just not the tonic Australian Financial Review May 7, 2005 (referring to the 2002 undertaking)
Raymond Walker who, I believe, is the same person who was a director of insurer HBA and of Australian Medical Enterprises (AME - Tenet/NME's Australian venture) in the early 1990s moved from LifeCare to IPN. In 1994 Walker strongly resisted my efforts to force AME to confront concerns about the suitability of Tenet/NME administrators running the Australian operation. Instead they tried to sue me for defamation.
Directors: Mr Robert Peter Campbell (Chairman), Mr Richard G Bevan, Mr William Denis Boyd, Mr Michael Denis Boyd (Non-Executive), Mr Raymond Walker (Non-Executive)
Independent Practitioner Network Ltd. Jobson's Year Book January 20, 2003
and closing facilities
IPN continued to have difficulties It sold its hospitals and some clinics, one to its founder Michael Boyd getting rid of all non-core assets. These were business decisions and there is no suggestion that the needs and hardships of the community were considered.
The Company today entered into a Business Sale Agreement with Healthscope Ltd under which Healthscope Ltd will purchase the hospital and radiology assets owned by the Company at the La Trobe University Medical Centre ("LUMC") in Melbourne, Victoria.
The Company will continue to operate the general practice and physiotherapy businesses at the LUMC, - - - - -
Independent Practitioner Network Limited (IPN.AX) Sale of LUMC Hospital to Healthscope. Australian Stock Exchange Company Announcements December 24, 2002
In sections 12.1 and 19.3, the EBITDA loss of the La Trobe Medical Centre Hospital for the current reporting period should be stated as $559,000, not $770,000.
Independent Practitioner Network Limited (IPN.AX) Appendix 4B - Supplementary Information/Director`s Statement. Australian Stock Exchange Company Announcements March 19, 2003
Yesterday the Company completed the sale of the Cottesloe Medical Centre. The Centre was purchased by a company associated with the Company's Chairman, Mr Michael Boyd.
Independent Practitioner Network Limited (IPN.AX) Sale of Cottesloe Medical Centre completed. Australian Stock Exchange Company Announcements March 13, 2003
Ashmore Family Practice closed last week and the five GPs working there have scattered around the Coast. The centre's two part-time and three full-time doctors treated about 800 patients a week.
One source at the centre said elderly and chronically ill patients had been left in the dark about where their GPs would be going after the closure.
Foundation Health-care said the move was a business decision based on the escalating costs of running medical centres.
Ashmore medical centre shuts doors The Gold Coast Bulletin March 12, 2004
Independent Practitioner Network Limited (IPN.AX) Agreement to sell the Cliveden Hill Hospital business.
Australian Stock Exchange Company Announcements November 17, 2004
Billing - increasing fees
Sonic encouraged its doctors to abandon bulk billing and increase their fees. While this increased its income it reduced attendance's as patients went elsewhere - and these patients were unlikely to come back.
The popular Derby St and Henry St medical centres in Penrith, both run by Foundation Healthcare, ended bulk billing on December 1. A spokeswoman said GPs could no longer make ends meet on the Medicare rebate.
Pushing up fees
Older patients feel the pinch. Penrith Press February 21, 2003
Independent Practitioner Network Ltd today warned EBITDA for the second half would be 30 per cent to 35 per cent below budget.
Patient volumes for the second half have been about 6 per cent below target volumes.
(AEIPN) Ind Prac Network 2nd-half EBITDA down 30pc to 35pc Ralph Wragg Australian Business News July 1, 2003
Private billing per patient has already increased from $27.2 to $38.6 since FY01. However, the increased billings have come at the expense of patient numbers per doctor hour, which have fallen from 4.6 to 4.0 over the same period, reflecting increased service. Billings will probably continue to improve while patient numbers per doctor hour level out at around 4.0. The net effect on revenue of this change on mix is positive.
INDEPENDENT PRACTITIONER NETWORK LTD (IPN) $0.06 Smaller Companies Guide October 1, 2003
IPN blamed its dismal financial performance on a 5 per cent decrease in patients flowing from a nationwide decline in bulk billing.
"In general practice, the shift away from bulk billing has seen the number of patient consultations decrease, with the revenue per consultation increasing to an average of $38.60 (2002: $33.57)," the company said in its annual report.
IPN's poor result comes as its billings per patient increased from $27.17 in 2001 to $38.60 per patient in 2003. Total doctor billings rose from $83.5 million in 2001 to $121.5 million in 2003.
Medical Centres Bleed $40m Australian Financial Review October 27, 2003
Like LifeCare it ran advertorials in local newspapers
Dr. Alan Carless, general practitioner and Foundation HealthCare medical director, said many life threatening illnesses common to Australian males, including heart disease, cancer, and diabetes, can be prevented or delayed.
Men's Health article
Located at 279 Macquarie St, Liverpool, the medical centre is open 7 days a week. To book an appointment phone 9821 2111. The centre is part of the Foundation HealthCare network.
Men need to care Liverpool Leader September 3, 2003
Doctors and Physiotherapists
Shares once over $2 were trading at 5 cents. Doctors and other professionals many of whom had lost money as the value of their shares plummeted now found themselves coping with cost cutting - something which far too often compromises care. How many went elsewhere we don't know.
IPN has added to the reputation for disappointment of its predecessors, Foundation Health Care (FNC) and Life Care (LCH), by downgrading its FY03 profit forecast from the forecast made in the scheme document for the merger of the two companies - - -
IPN is now clean, ie. free of all non-core assets.
INDEPENDENT PRACTITIONER NETWORK Smaller Companies Guide March 19, 2003
Mr Michael Boyd today resigned as director and Chairman of the Company. Mr Wayne Peters has been appointed as director and Chairman of the Company,
Independent Practitioner Network Limited Australian Stock Exchange Company Announcements March 25, 2003
At the other end of the spectrum, shares in Independent Practitioner Network were off 3.2 cents at 5.5 cents
A little levity amid depression. Australian Financial Review July 2, 2003
IPN just slashed its profit forecast for this year by 35 per cent after recording a loss of $461,000 in the second half of last year.
IPN's patient volumes have fallen 6 per cent but some doctors complain that cutting costs will lower standards. As an example, they say rents aren't being paid and they are being forced to borrow vaccines from other centres in the group rather than buy in fresh. "They have cut everything including staffing costs and medical resources to the bone," said one doctor contracted to IPN who asked not to be named.
The national doctors shortage makes it hard to discipline angry medical staff. Several IPN contract doctors told the Weekend AFR they would walk out if their demands weren't met.
IPN, on the other hand, takes a 50 per cent management fee but doctors complain it also takes a percentage of the federal government's practice incentive payments. Some doctors took IPN shares in payment for their medical centres and are now locked in.
Doctor, Doctor The Business Is Sick Australian Financial Review August 9, 2003
Twelve physiotherapy clinics have not renewed their franchise agreements with LifeCare Physiotherapy, opting instead to start their own consolidated structure, Active Physiotherapy.
Active spokeswoman and Galleria Morley Physiotherapy practice principal Suzanne Blunt said the new five-year franchise agreements offered by national group LifeCare were less than ideal, so clinic owners decided to start their own group.
Active moves with new physiotherapy business WA Business News November 25, 2004
part of Sonic
By 2004 IPN was no longer viable and was being sustained by Sonic's support. Primary Healthcare put an end to the farce by making a takeover bid for IPN. Sonic was forced to counter with a bid which gave it total control of IPN. In 2005 it bought the remainder and IPN became a wholly owned subsidiary of Sonic. These recent developments and the takeovers are described fully on the Sonic page.
Click Here to go to the beginning of the Sonic page
Click Here to the section on the Sonic page describing Foundation, IPN and the merger with Sonic
Click Here for a chronological account of Foundations progress and for References.
Click Here for information about LifeCare and the similarity of its practices to those in the USA.
This page created June 2002 by Michael Wynne
Updated and reformatted January 2006