For a quarter of a century, Praxis Medical Group LLC has been steadily growing, acquiring smaller, unique medical groups and incorporating them into its Oregon network of primary care doctors and specialists.

Last year it acquired Desert Orthopedics in Bend. On Feb. 3, Praxis acquired South Salem Primary Care Center on Skyline Road South in Salem. With these acquisitions, Praxis has 250 providers who care for patients from Pendleton to Eugene.

For Praxis, the past decade has been growing about 20% to 30% year over year, said Dan McCarthy, Adaugeo regional administrator. 

In all, Praxis employs 1,200 employees. When it began in 2007 it had 45 statewide, said TK Kennedy, Adaugeo Healthcare Solutions CEO. Adaugeo is the management group of Praxis’ health care companies, providing human resources, payroll and the other back of the office workforce.

“We’re the largest medical group that no one has ever heard of,” Kennedy said. “In my own experience, it’s easier to grow a company, develop relationships with people when we are not self-promoting. I think people are overwhelmed by that. We’ve always been low key.”

Like other industries, consolidation is part of an increasing trend. Often smaller practices find it expensive to maintain medical records and onerous to compete against large hospital systems that can share economies of scale. 

Family affair

The medical group is run by the Kennedy family from their hometown of Pendleton. It started with Tom and Judy Kennedy who began the company with the purchase of Interpath Laboratory in Pendleton in the 1980s, Kennedy said. The family expanded the laboratory holdings throughout Oregon, Washington, Idaho, Alaska and northern Nevada.

It is run by the elder Kennedys and their sons, Tyler, Kacey and TK.  

“We actively are growing,” said Kennedy, 50. “We’re primary care focused, but with all the specialty groups we’ve had, we at some point have specialty care involvement.”

In 2005, the company bought High Lakes Health Care of Bend, a primary care facility, which is the backbone of the family of clinics. Primary care physicians, however, were asking for more specialists for referrals, and that’s why Praxis began looking for an orthopedic group, McCarthy said. That’s why the group purchased Desert Orthopedics.

“We originally weren’t looking at someone to buy us out of private practice,” said Dr. Erin Finter, a founder of Desert Orthopedics. “We were intrigued because they were a local entity and we’d continue to practice with better resources and to have the ability to have better electronic medical records and meet the Medicare guidelines that we have have been having trouble with.”

The family of companies includes labs, surgical centers, real estate development and medical clinics, Kennedy said.  

Praxis’s goal is to blend into the four walls of the medical examination room and allow the patient and the provider to work together, McCarthy said. When Praxis acquired Desert Orthopedic, the connection and relationships to primary care providers in the community were important, McCarthy said.

“We’ve always understood that there’s a space for a more personable relationship between the patient, the company and the provider,” McCarthy said. “We’ve been successful at creating that relationship. We’re physician owned, independent minded individuals. “We protect that intimate space between the provider and the patent without the corp structure getting in the way.”

What attracted High Desert Orthopedics, Finter said, was that Praxis is a local family group. The doctors at the Bend orthopedic group wouldn’t have to change their hours, take on larger patient loads or change the way they treat patients. 

“We were not told about what hours and how to treat patients and how our day needs to go,” Finter said. “There really wasn’t any change in what we do and our ability to see patients as physicians.

“It’s been great from that standpoint.”

That kind of independence isn’t always assured, although promised, said Dr. John McConnell, Oregon Health & Science University Center for Health Systems Effectiveness director and health economist. 

McConnell called this vertical integration when a hospital group snaps up physician groups to expand its footprint. It’s a phenomenon that is occurring with regularity across the nation. 

“The national data is strong,” McConnell said. “Some scrutiny and understanding show that there’s a trade-off. There’s less of a strong voice for the consumers. And buying these physician practices doesn’t always lead to lower costs and better care.”

In Central Oregon, the three big medical groups are St. Charles Health System, which operates a four hospital network in Bend, Prineville, Madras and Redmond, and Bend Memorial Clinic, which is owned by Summit Medical Group Oregon with medical clinics in Bend, Redmond and Sisters.

Looking ahead

Going forward, Praxis wants to be the primary care business leader with medical clinics in every major market. They’re nearly at their goal with facilities in five markets: Portland, Salem, Eugene, Bend and northeast Oregon. The only part of the state left is southern Oregon, Kennedy said. 

“Health care is unique,” Kennedy said. “I believe it lends itself to the empowerment model. My experience is that the top down approach doesn’t work in health care. You have to build up from the bottom.

“People are attracted to working in a place that affords autonomy and that’s what works best.”