By Mary Jo Feldstein, St. Louis Post-Dispatch, August 24, 2006

Washington University School of Medicine and Barnes-Jewish Hospital have begun construction of a new, $13 million outpatient orthopedic facility in Chesterfield. The 60,000-square-foot facility will include physician offices, examination rooms, ambulatory surgery suites, diagnostic radiology and rehabilitation services.

The center''s surgeons, physiatrists, radiologists and anesthesiologists will be Washington University physicians. Barnes-Jewish Hospital will manage the ambulatory surgery center and the radiology services.

The facility is a relocation and expansion of services offered at the physicians'' offices near Barnes-Jewish West County Hospital. Dr. Richard Gelberman, chairman of Washington U. orthopedic surgery department, said patients found the facility convenient, but physicians outgrew the space.

"As it''s been possible to do more and more on an outpatient basis...this sort of facility becomes more attractive," Gelberman said. This expansion of outpatient services is part of a nationwide trend. Improved imaging technologies and new surgical techniques have helped fuel an 11 percent jump in spending on outpatient services in 2004, the most recent year available.

It was the fourth consecutive year outpatient services outpaced all other categories of health care spending, according to the Center for Studying Health System Change, a Washington think tank. In many cases, physicians have pooled their money to open outpatient centers, joined up with hospitals, or hospitals have opened the facilities on their own. For this facility, Washington U. split the cost with Barnes. The physicians will not be investors. Washington U. has prohibited its physician faculty from investing in outpatient centers, saying it violates the school's policies.