SANTA ROSA -- The Annadel Medical Group has added 20 physicians over the past 10 months, an accelerating pace that makes it one of the fastest-growing medical groups in the region at a time when health systems across the country seek to attract more physicians.  

Annadel, which is affiliated with St. Joseph Health Sonoma County, is also starting two new specialty practices, in gastroenterology, which focuses on the digestive system, and OB/GYN -- both important specialties that will enable physicians to provide more comprehensive care, the medical group said.

"It's really being driven by patients and physicians," Bob Just, director of operations for St. Joseph Heritage Healthcare and the Annadel Medical Group, said of the recent growth.

Annadel started with seven physicians in 2008. Since then, it has grown to 50 physicians and 10 nurse practitioners -- across numerous practice areas, but with a heavy emphasis on primary care.  Most recently, the group added 13 physicians, its largest single addition since its inception.

While the group has grown at an impressive rate recently, St. Joseph Health in the past has struggled to match the growth rate of foundations operated by its biggest competitors. Back in 2002, shortly after the Santa Rosa-based HMO Health Plan of the Redwoods shuttered, St. Joseph Health altered its strategy related to medical foundations, opting to focus its resource on other areas of care, according to Mr. Just.

"There was a different foundation model back in the '90's," Mr. Just said. "When HPR folded, at the time it was perceived to be a time to get out of a business that was losing money. I think the reality is, had we stayed the course, we probably would have found ourselves in a more favorable position. We had to come with seven physicians instead of 80 or 90."

But the recent efforts to grow the foundation are paying off, Mr. Just said, adding that the size of the group, while important, is not the only metric of a successful foundation.

An important metric both Mr. Just and Annadel President Dr. David Smith noted is that the recently added doctors include several longtime, established and respected Sonoma County physicians, giving the group a legitimately local feel.

There's also a healthy mix of new recruits to the region, Dr. Smith said.

Other health systems have similarly invested heavily into physician foundations, largely as a means to secure doctors -- and perhaps their patients -- in lieu of health care reform and anticipated physician shortages. The same is driving Annadel to aggressively seek out new physicians, which will not only help it adapt to health care reform but will also expand the level of services to more patients.

Increasingly, as is the case across the health care landscape, physicians are aligning with larger groups and are more amenable to foundation models than perhaps in the recent past, Mr. Just said.

"There are two factors -- one is that (physicians) all see the changes coming with heath care reform and they want to get ahead of that," he said. "And then I think there's other people who have been in their own private practices for years, and they're just sort of tired and want to practice medicine. We find people are eager to get rid of the administrative duties -- that tends to motivate the most people. Then there are others who are looking for a change of scenery."

Dr. Smith, president of Annadel, said he expected more physicians to join the group. He also noted the changing scenery for physicians, but he stressed that it's overall a positive development that fundamentally shifts the focus of care to preventive, integrated models that produce better outcomes.

"Almost certainly, more physicians will be added," he said. Primary care, he continued, "is where most patients will encounter their doctors." This is the main thrust of the organization, and needed medical specialties as it seems appropriate from the physician community will be added.

"The whole thrust of medical care in this country simply has to have better values," Dr. Smith said. "One of the best ways to get value for our premiums is to have integrated, efficient ways of care."

The growing Annadel model does just that, Dr. Smith said, which is in line with the goals of health care reform.

"Most people in primary care, and I'm one of them, are fans of the Affordable Care Act. The amount of value is good. It's about the number of preventive services. And that's great value for a trivial increase in cost," he said. "Health reform, which is largely insurance reform, is the logical way. It's not a government takeover."

Annadel Medical Group is the local physician organization that partners with the St. Joseph Heritage Healthcare medical practice foundation and St. Joseph Health, which operates Petaluma Valley Hospital and owns Santa Rosa Memorial Hospital and Queen of the Valley Medical Center in Napa.