published Wednesday, August 4th, 2010

Hospital losing specialty coverage


by Emily Bregel
  • photo
    Staff Photo by Danielle Moore Hutcheson Medical Center in Fort Oglethorpe, Ga., recently announced an expansion of cardiac services. The program, which is affiliated with Saint Joseph's Hospital in Atlanta, will allow heart cath patients to receive stints during the same surgery.

Facing the loss of emergency room coverage in cardiology and pulmonology, Hutcheson Medical Center leaders are trying to line up replacement specialists.

“We’re working to solve the problem before it becomes a problem,” Dr. Steve Perlaky, chief of staff and assistant director of the Hutcheson emergency room, said Tuesday.

Hutcheson will lose its only two intensive care and lung specialists at the end of the year, when Battlefield Pulmonary leaves to join Memorial Hospital.

The ER also is on track to lose on-call cardiology coverage at the end of August, when Dr. Marvin Mills will stop taking calls around the clock.

Mills, who will continue to care for all his own patients, has been the hospital’s sole on-call cardiologist since Diagnostic Cardiology Group left the hospital in October. He declined to comment.

“Being the only on-call cardiologist for the length of time he has is a substantial burden,” Perlaky said. “Many times I’ve called him in the middle of the night because there’s been a patient with chest pains and he’s always been cordial, gracious and willing to help. It’s not like he’s abandoning us; he’s paid his dues.”

Perlaky said the hospital could recruit another cardiologist or pay for call coverage on a per-diem basis.

“I don’t envision us to be without cardiology Aug. 31. We’re working hard to resolve that,” he said.

The ER losses would be major blows to Hutcheson. Local doctors have said they would hesitate to admit patients without having specialty coverage for an emergency.

Dr. Magdalena Kowalski with TCFPA Family Medical Center in Ringgold, which has been a major source of patient referrals for Hutcheson, said the practice is waiting on word about cardiology coverage.

“There’s no reason for us to be concerned right now, but in another three weeks there will be,” she said.

Hutcheson President and CEO Charles Stewart said in an e-mailed statement that the hospital will avoid any lapse in ER coverage.

“We are in discussion with other pulmonary physicians and it is our plan to have secured coverage for our pulmonary patients by the time our contract concludes” with Battlefield Pulmonary, he said. “Dr. Mills and I are having ongoing discussions regarding how we can provide the support and relief he needs to give him the reasonable time off and meet the needs of the hospital.”

BRINGING PATIENTS BACK

A partnership with an outside facility appears increasingly likely in order to bring doctors back to Hutcheson, doctors and members of the hospital’s three boards have said.

Hutcheson’s roster of admitting physicians and employed specialists has dwindled in recent years, as many doctors have affiliated with hospitals in Chattanooga.

Erlanger hospital, Parkridge Medical Center and Memorial Hospital also have expanded into North Georgia, opening satellite offices and clinics there.

To date this year, Hutcheson has averaged 42 patients a day in its 195 beds, and it’s losing money.

Low patient counts make it hard to recruit new specialists, and a lack of specialists, in turn, makes it harder to attract patients and referrals, said Dr. Lori Emerson, pathologist and medical director of Hutcheson’s laboratory. She is former chairwoman of Hutcheson Medical Center’s board and has worked at the hospital since 1992.

“Once you get to a certain point of not having enough patients, it gets to be a vicious cycle where you don’t have enough patients to support a specialist,” she said. “Really, what we need are doctors of all types. We need to get our doctors back and restore some of the relationships that we’ve had in the past.”

Nevertheless, she noted that patient satisfaction rates are high and Hutcheson ranks among the best in hospital quality measures.

Hutcheson was recognized by the Georgia Medical Care Foundation — the state’s Medicare quality improvement organization — for reducing surgical complications, according to a hospital news release on Tuesday.

“It’s really ironic that, at the time we’re moving up with other measures, we’re seeing these declines in volumes, primarily related to the problems with physician relationships,” Emerson said.

The loss of paying patients hurts even more because of how many patients Hutcheson treats who can’t pay for their care, Perlaky said.

“I do think it’s important for people to be aware of the support the hospital has been to the community through the years,” he said.

JOINT BOARD MEETING

Last week, the hospital hired Plano, Texas-based Community Hospital Corp. to help determine if there’s a way to maintain independence and local control while collaborating with a larger facility.

Community Hospital Corp. President and CEO Mike Williams spoke about partnership possibilities at a joint meeting of the three hospital’s boards Monday, said Jim Emberson, a board member of Hutcheson Medical Center Inc., which leases the hospital building from Catoosa County.

“The hospital is not in near as bad a shape as people seem to think it is,” Emberson said. “I think we’ll look back on it all and say this has been a turning point. I just have a good feeling.”

The board of trustees of the Hospital Authority of Walker, Dade and Catoosa counties — which oversees the terms of the hospital’s lease — and members of the Hutcheson Health Enterprises board were present at Monday’s meeting, as well.

The meeting was held in executive session, so the public could not attend.

Emerson said she believes a partnership with another hospital will be necessary to recruit staff physicians, and she hopes any agreement will retain as many local staff positions and North Georgia-based medical services as possible.

“That is critically important to me, because I love this hospital and this community needs this hospital,” she said.

Continue reading by following these links to related stories:

Article: Hutcheson looks for life support

Article: Troubled hospital weighing options

Article: Struggling Hutcheson seeks partners

about Emily Bregel...

Health care reporter Emily Bregel has worked at the Chattanooga Times Free Press since July 2006. She previously covered banking and wrote for the Life section. Emily, a native of Baltimore, Md., earned a bachelor’s degree in American Studies from Columbia University. She received a first-place award for feature writing from the East Tennessee Society of Professional Journalists’ Golden Press Card Contest for a 2009 article about a boy with a congenital heart defect. She ...

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Comments do not represent the opinions of the Chattanooga Times Free Press, nor does it review every comment. Profanities, slurs and libelous remarks are prohibited. For more information you can view our Terms & Conditions and/or Ethics policy.
diegochase4 said...

You should be fined for not having insurance because if you have an emergency and go to the emergency room, then you do not have the money for the bill, it gets charged to everyone else. Get medical insurance for your entire family at the best price from http://bit.ly/chE6zp. By contributing to the pool and doing your part, overall costs come down. Its like stores that have to charge more because of all the theft. People go to the hospital and then not pay, it gets charged to everyone else.

August 4, 2010 at 4:44 a.m.
ann said...

diegochase4,sounds like you agree with obama care which has already made a lot of changes that are not good,why cant people pay on their bills monthly like we have always done ,and just because you have insurance doesnt take care of everything you still have all these copays plus co-insurance that has to be paid,what they need to do is charge all these illegals for the service they get and we would not have all these problems,if insurance company"s didnt charge so much people might be able to afford it,everything has gotten out of control since the goverment has got into it they always get over charged then pass it on to the taxpayer which is the working person,so we dont want to pay anymore for these illegals send them back to mexico and where ever else they came from

August 4, 2010 at 9:46 a.m.
mkelley said...

“The hospital is not in near as bad a shape as people seem to think it is,”

Ok then, when else have patient numbers & referrals been this low? I don't recall this many people being fired or laid-off in the previous 20 years from HMC.

August 4, 2010 at 12:46 p.m.
hambone said...

Obamacare, you mean the "Patient Protection and Afordsble Care Act" The insurance and drug cartel spent billions trying to stop it. Do you really think they were doing it for you? Follow the money and think for yourself people. Stop letting the GOP and the talking heads at Foxy News do your thinking for you!!

August 4, 2010 at 1:04 p.m.
FM_33 said...

Health care is only a fantasy in side the mind of the powers that be.

August 4, 2010 at 5 p.m.
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