Fueled by the disintegration of the traditional silo business structure separating hospitals and physician practices, the Providence Medical Group is on a growth streak that doesn't look like it will end anytime soon.

PMG, the newly renamed physician-services unit of the big Providence Health Services & hospital network, based in Renton, Wash., has grown its Eastern Washington ranks here to more than 200 doctors during the last several years, and potentially could add another 100 doctors during the next five years or so.

That's the guesstimate of Dr. Kevin Sweeny, its chief medical officer, who says the growth will be driven by a need to fill remaining gaps for certain types of specialty care and also to respond generally to rising demand, Sweeny says.

To date, he says, "It's been organic growth to really accommodate the needs of the population," particularly the large group of aging baby boomers that's expected to put heavy demands on the health care system for years to come.

Along with a current total of 217 doctors, Providence Medical Group Eastern Washington includes 43 advanced practitioners, including physicians' assistants and nurse practitioners, and 377 support staff members.

By comparison, at the beginning of 2010, the doctors' group—then operating under the name Providence Physician Services Co.—had only about 70 doctors and five advanced practitioners, plus a fraction of the support staff it has now, he says.

It now has more than 40 medical clinics serving Spokane and Stevens counties, with its doctors and other health-care providers offering expertise in family and internal medicine, pediatrics, obstetrics/gynecology, dermatology, and other specialties.

It's part of Spokane-based Providence Health Care, the Inland Northwest's largest health care system, which encompasses 10 hospitals and organizations that altogether employ more than 8,000 people.

Providence Health Care, in turn, is part of Providence Health & Services, a Sisters of Providence-sponsored nonprofit ministry that's among the largest health-care systems in the U.S. It includes 27 hospitals, 214 physician clinics, senior services and supportive housing, a health plan, a liberal arts university, and other facilities and services. It employs more than 45,000 people in five states.

PMG physicians are employed by Providence, but Providence facilities also continue to have close relationships with many doctors and other health-care providers who continue to operate independently, Sweeny says.

Of the more than 200 doctors in the group, about 60 are primary-care providers, about 60 are in surgical subspecialties, and the rest are in medical specialties, such as nephrology, neurology, and gastroenterology, he says.

On June 1, the group will be adding another 24 physicians and five advanced-practice providers.

"We're seeing a lot of growth in primary care. There's an absolute need for more primary-care services in the region," he adds. "The Medicare population will be growing rapidly over the next 25 years."

The federal health-care reform act and sweeping changes in how Medicare reimburses health-care providers for their services are driving the current trend, here and nationally, toward alliances between physician groups and hospitals, Sweeny says.

Regardless of how that all plays out politically, it's clear that people who currently don't have health insurance "are going to become insured in some shape or form," so there is a critical need for greater collaboration to ensure services are provided as efficiently as possible, he says.

Among employers, providers, and insurers associated with Providence, there's now an intense desire for everyone to work together, Sweeny asserts.

"For us, we need to maintain our fiscal viability, our fiscal stability. I think it's working well," he says. "The challenge is, how do we move away from the current underfunded model? Our belief is you do it incrementally. I think we're optimistic we're doing the right thing."

He notes that 95 percent of health care is provided in an ambulatory setting, and the federal push now is on providing "a patient-centered medical home," focused on keeping patients healthy through a collaborative team approach, rather than simply treating diseases. That focus is the catalyst for the health-care alliances now taking place.

Dr. Mo Nunez is CEO of Providence Medical Group-Eastern Washington, and Kathy Tarcon is COO. Providence hired Sweeny last fall. He formerly served as CEO at Rockwood Clinic, and practiced family medicine at Rockwood for 15 years before becoming its chief executive in 2005. As PMG's chief medical officer, Sweeny says his responsibilities include the recruitment of doctors, and he says one of his challenges will be filling vacancies of aging physicians who will be retiring in coming years.

Overall, though, he says, the recruitment effort has been going well.

"We're seeing improvement, I think, because of our philosophy," he says, describing PMG as professionally managed, but physician led.

"Our belief system is that providers are an important partner. As a recruiter, I seek partners. I don't seek employees," and Providence puts a lot of emphasis on physician leadership, he says.

"Philosophically, we are to trying to create a partnership model," he says, adding, "I feel like we're doing that. I hope we're doing that. The biggest challenge is making sure physicians believe they're an important part of what we're doing."