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Cancer center dust-up looks settled

Posted: February 11, 2012 - 8:12pm

The two entities pushing for cancer treatment services in the area may have worked through a recent impasse that stemmed from competing plans to build a local cancer center when the community can only support one.

Central Peninsula Hospital, under the direction of Chief Executive Officer Rick Davis, and the newly formed Peninsula Cancer Center, under the direction of Anchorage-based Dr. John Halligan, both want to bring radiation oncology services to the central Peninsula but differed on the best way to do that.

The scuffle revolved around where and how fast the center could be built.

Halligan wanted to build his own facility off, but near the CPH campus, own the land it sits on and charge for both professional and technical fees associated with cancer treatment.

CPH wanted to build a facility to house radiation oncology services and eventually others as part of a larger cancer treatment operation on its campus and lease out the building to radiation oncologists, who would still collect the professional and technical fees.

However, it now seems CPH will be backing away from its plans and seeking to work along side Halligan.

On Wednesday, the Kenai Peninsula Borough released its draft Feb. 14 agenda, which included Ordinance 2011-19-72 calling for appropriation of $4.7 million for CPH to build their cancer center.

However, Davis said Friday the assembly “probably” would pull that item from the agenda to allow Halligan to proceed with his plan.

“There is obviously not room for two and the assembly is not going to approve ours with somebody offering to do it themselves across the street, so we are pretty much dead in the water,” Davis said.

“The comprehensive cancer program idea won’t happen now. It’ll be fragmented cancer services kind of scattered around.”

However, Davis said it is still a benefit for the area to have the services, despite the location.

Halligan agreed.

“We will have ongoing talks but it is almost certain this is the approach that is going to happen,” Halligan said. “But, we are going to work carefully with the hospital even as we move along because I do want to build a comprehensive program.”

Halligan said he did “seriously” consider a request for a letter of interest from CPH — the same one that was also sent to Dr. Richard Chung of the Anchorage & Valley Radiation Therapy Centers, who is the only other radiation oncologist in the area. Chung was interested in partnering with the hospital, Davis said, but Halligan didn’t respond.

“It was a difficult decision,” Halligan said. “There are a lot of pros and cons going back and forth in the two programs, but we think this will actually work out between us, internal medicine, and medical oncology all right there and right across from the hospital.”

Language in the borough ordinance reads that if the “private physician group remains committed to constructing a facility off campus, this ordinance will not be necessary.”

“However, in order to meet a construction timeline for the upcoming building season and to provide for public notice and hearing requirements, this ordinance is being introduced while discussions continue about the best approach for moving forward on this needed service,” the ordinance reads.

Kenai Peninsula Borough Mayor Mike Navarre said the “bottom line” is that all patients have to leave the area currently and “it’ll be better whether it’ll be on campus or off campus because there is not room for two facilities.”

“We will embrace that and start working on other things,” Navarre said of CPH backing away and allowing Halligan to build his center. “It is the reasonable approach.”

 

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Smith1rk
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Smith1rk 02/12/12 - 02:31 pm
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Watch CPH wither away

Mayor Navarre is wrong. This is not the "reasonable approach". It is the KPB "kowtowing approach" that will eventually lead to the demise of CPH and SPH. Greedy physicians are on the move on the Kenai Peninsula. Independent physicians will eventually have a surgery center, diagnostic imaging center complete with CT and MRI, and a cancer treatment center. While not inherently bad, don't be surprised to see your property tax bill increase, and the value of your community hospital plummet, while the price of these services will stay the same in these "independent" settings. The dream of a Planetree Cancer Center on the CPH campus is over. If you are diagnosed with cancer, get ready to be treated like a number in a sterile radiation treatment center, that will operate with the interests of the for-profit entities in mind, as your dollars flow off the peninsula to line the pockets of physicians in Anchorage, and their partners in Tennessee. Good luck with lowering the cost of healthcare on the Peninsula, let me know how that one works out for the patients and taxpayers. Ryan Smith

Carver
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Carver 02/13/12 - 08:24 am
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Thanks . . .

Thanks for the input, Ryan. Dr. Richard Chung operates radiation treatment centers in Anchorage and in the valley. I was referred to Dr. Chung in the fall of 2010 and chose the valley center because our daughter lives up there. Let me assure you that Dr. Chung and his staff did not treat me "as a number," nor was his radiation center "sterile." Dr. Chung and his staff bent over backwards to accommodate me and my schedule; they were polite, caring, and helpful.

Don't quite know what to say about CPH beyond that area residents quite plainly do not want to sell the hospital to outside interests. That said, I imagine it unlikely that CPGH Inc. has the ability to run CPH as a health-care monopoly in the current corporate and regulatory climate.

Inc. would, I think, be better advised to learn how to work amiably with area physicians both here and in Anchorage rather than trying to run the show and dictate terms. That kind of high-handedness might have worked if CPH had been sold to some high-dollar corporation, not otherwise.

As a small, locally-owned hospital, CPH simply hasn't the economic clout or the managerial expertise to compete with independent physicians. CPH needs to reclaim its initial vision as a facility for physicians to ply their trade, nothing more. CPGH Inc. should be replaced by an elected board.

Dr. John Halligan
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Dr. John Halligan 02/13/12 - 08:56 am
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Response by Dr. John Halligan

Dr. Blom and I have committed to bringing the highest quality and most up to date radiation oncology services to the Kenai Peninsula. We have always treated our patients in Anchorage with great respect and compassion and certainly will continue that level of caring and compassion for our patients when we bring our clinic to Soldotna. Whether we would be treating our patients at a facility across the street from the hospital or on the grounds of the hospital, our focus will be on the patients, families and the exemplary care they receive from us as physicians, our technical staff and our clerical staff. I have greatly appreciated the work of Mr. Rick Davis over the last 2 weeks as a final decision was made and look forward to working closely with him as our center moves forward.

Patients will have immediate and convenient access to both their radiation oncologist and medical oncologist as well as internal medicine physicians as we coordinate and manage their cancer care in a multidisciplinary team approach. We will coordinate closely with our surgical colleagues in the community both in person and at tumor boards at the hospital, as we have done for the past two years.

Dr. Blom and I have successfully had our cancer program in Anchorage certified by the American College of Radiology (ACR) and the American College of Surgeons Commission on Cancer, demonstrating the highest level of clinical and technical competence and quality assurance. We are the only center in the state to achieve ACR certification. We intend to continue this level of clinical and technical excellence on the Kenai. We intend to bring a patient centered, warm and comfortable center to the Kenai. We have always focused on patient centered care and will continue to do so.

Mr. Smith first asked me personally to bring cancer treatments to the Kenai on my first visit to Soldotna shortly after I first arrived in Anchorage 4 years ago. I wish to express my extreme surprise and disappointment at his vitriolic and inappropriate comments. Anyone who knows or has been treated by Dr. Blom or myself, can attest that we always respect, embrace, and treat each patient as if they were our neighbors and friends. We are thankful to bring cancer treatment locally to the Kenai John B. Halligan, M.D.

Hoyt1jc
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Hoyt1jc 02/13/12 - 10:45 am
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Unfortunately...

Carver, I have followed your posts for sometime and must say you have some insight into what is going on. Unfortunately "some insight" allows for a reletively one sided and shallow perspective. Pretty easy to sit on the outside and lob grenades. Easy but extremely unproductive.

The hospital is there first and foremost for the patients NOT the doctors. While docs are a very important constituancy, we should be keeping our eye on what is best for the patient. Its too bad we won't get the opportunity to vet Dr Chung against Dr Halligan, but rather the community gets no say because Dr Halligan chose to take advantage of the political climate and completely misrepresent the story to the public and the hospital board. Maybe if you don't quite know what to say about CPH, you should take the time to get completely educated. JHoyt

Carver
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Carver 02/13/12 - 02:35 pm
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"Completely" educated? . . ;-)

Hoyt1jc:

First, you are mistaken: I do know what to say about CPH—I have my opinion and you have your opinion. Please reread my post above for my opinion. (". . area residents quite plainly do not want to sell the hospital to outside interests. That said, I imagine it unlikely that CPGH Inc. has the ability to run CPH as a health-care monopoly in the current corporate and regulatory climate.")

Moreover, I take it that by chiding me to become "completely educated," you really mean "see it your way"?

Second, your patronizing and abusive comments directed against me and against Dr. Halligan—"shallow perspective," "lob grenades," "completely misrepresent"—amount to nothing more than opinionated, personal insults and add nothing of substance to the discussion.

Very disappointing.

Hoyt1jc
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Hoyt1jc 02/13/12 - 02:05 pm
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Wow

Gee Carver, I guess only your perspective matters. Once again, you have a lot to complain about, but do nothing personally to involve yourself in the real issue.

Maybe you should read your own post. It clearly states you "don't quite know what to say about cph beyond local residents don't want to sell to outside interests".

Obviously, when someone points out that you should get completely educated since your quite vocal opinions speak to only one side, you resort to vitriol like someone has made some personal attack. Sad, but not at all surprising.

There are those whom have invested thousands of hours over many years to build our hospital into one of the finest facilities in the country for an area our size and there are those who hide behind the anonymity of the web and complain. Which camp do you fall in?

Carver
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Carver 02/13/12 - 02:30 pm
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Let's be fair . . .

No, Hoyt1jc,

Mine is not the only perspective that matters, nor is yours. My perspective speaks to one aspect of the issue; your perspective speaks to another aspect of the issue.

This forum is supposed to facilitate adult discussion of issues and should not degenerate into a platform for pompous condescension, insults, and libelous accusations. So far, I'm very disappointed in the level of conversation in this thread: greedy doctors, stupid opinions, lying testimony, and more, all coming from the same side of the issue.

If you wish to engage in substantive discussion, let's move on. Otherwise, you're welcome to your opinion as I am to mine.

Hoyt1jc
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Hoyt1jc 02/13/12 - 03:01 pm
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Couldn't agree more

I agree, lets be fair. I have an opinion based on education, involvement in all the issues of which you speak and a history of being there in the thick of things. I believe that would equate to knowledge. This is where you and I differ. I have knowledge and you have an opinion.

You seem to have fairly thin skin for someone who spends a lot of time opining about the current state of the hospital. Clearly when your opinions are challenged you chose to whip out the adjectives on how wronged you have been instead of letting everyone know what knowledge base you formed your opinions from.

Your posts strongly indicate you believe in an elected board. Perhaps that will be your call to action. Maybe you will lobby the assembly to terminate the lease and operating agreement with CPH, Inc and establish an elected operating entity. You may consider running for that board. If you are successful in that endeavor please let me know who you are and I will support your election campaign. With any luck you will get elected and find out the view from that seat is much different from the view on your couch.

I wish you the best - whoever you are. J Hoyt

Norseman
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Norseman 02/13/12 - 03:28 pm
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unsure

I do not have the information to determine which is in the best interests of our local hospital. What I do know is that it seems 1 out of every 2 or 3 people seem to get cancer. Having a Cancer treatment center here in Soldotna will be a huge benefit to the citizens of this borough. The odds are in my lifetime I will probably develope some form of cancer. I'd much rather be treated here locally than have to try and commute back and forth to Anchorage.

I have been here for decades and truly love our hospital. It has given nothing but the best services for my family. I just hope that we can keep our hospital owned by us and that it can remain financially sound during all of this new change heading our way.

Allen
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Allen 02/13/12 - 05:56 pm
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What Carver fails to tell you

What Carver fails to tell you is that Dr. Chung's radiation treatment center in the Mat-Su Valley is on the campus of the local hospital there. You can see this on http://www.anchorageradiationtherapy.com/locations.

The hospital campus is by far the best place to have a cancer treatment center, so that patients undergoing cancer treatment with complications don't have to be sent by ambulance to the local hospital. What a waste of our local resources, and more expensive to the patient than being at the hospital in the first place.

Dr. Halligan's proposal doesn't give us local control over cancer treatment, and makes us subject to the profit-making goals of a private company, just like when local doctors here stopped taking new Medicare patients. Our hospital stepped up and bought practices that don't discriminate against Medicare patients. When Dr. Halligan doesn't make enough money here and closes his center, where will that leave us?

It's a sad day when our Borough Administration abandons our long term interests because of what - the mayor is afraid of a little bad publicity?

Carver
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Carver 02/13/12 - 06:24 pm
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Malicious charges?

Allen,

"When Dr. Halligan doesn't make enough money here and closes his center," are very serious and malicious charges. Do you have proof of such intent on Dr. Halligan's part, or is your statement simply malicious supposition?

This is becoming a truly nasty thread. Greedy doctors, stupid opinion, misrepresentation, and now this. Very disturbing.

corinnep
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corinnep 02/13/12 - 06:36 pm
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Carver, you can't misquote a

Carver, you can't misquote a poster and then complain about it. The full sentence is "When Dr. Halligan doesn't make enough money here and closes his center, where will that leave us?" This is a rhetorical question, not as you claim "serious and malicious charges."

But I notice from reading the Clarion's online comments regularly that you are quick to attack those who disagree with your comments, and wrongly accuse them of being nasty and insulting. I also notice that you didn't deny Allen's comment that you left out critical information in your post.

Carver
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Carver 02/13/12 - 07:09 pm
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Dr. Chung's radiation center

Dr. Chung's radiation center is in an entirely separate building and totally detached from the hospital. It's a fair walk from one to the other.

I am surprised that the Clarion allows this sort of material—short on substance and long on abuse. The closest thing to substance I've seen posted yet is Allen's assertion that ". . when local doctors here stopped taking new Medicare patients. Our hospital stepped up and bought practices that don't discriminate against Medicare patients." Which "local doctors" have stopped taking new Medicare patients? Does anyone care to name names? Some seniors might find that information useful.

But is it true? How about it, local doctors? May we hear from some of you? Did your refusal to accept new Medicare patients cause CPH to buy practices so that area residents wouldn't be without the care you declined to provide?

Hmmm
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Hmmm 02/15/12 - 12:54 am
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Wow

Nothing gets more opinions posted than the hospital...

I would like my health care overseen by just one entity that is only interested in my health and not their on financial success.

Guess that's why there's so much interest here.

I hear an almost unanimous voice here that we don't want the hospital owned by outside interests, but that voice seems to waiver when we talk about the profitable parts such as a surgical or oncology center. It seems Dr. Halligan offers a very nice and professional service. He has made it clear though that he only wants to answer to himself and not to a non-profit group charged with oversight of the communities health regardless of profit margin. That results in a fragmentation of the unified health plan fo the community. As a private venture he, like the surgical center, would not be subject to the same government and accrediting agency scrutiny as the public hospital and could limit his clientele to only those who don't need Medicare or Medicaid in order to increase profits. So, the result will be the same here as it would be for a surgical center - high paying medical procedures going to private groups that meet less government standards leaving the low paying ones for our public hospital. Regardless of profit this leaves us with a less stable system compared to one overseen by the hospital. Profit considered, the hospital will be diminished compared to our present situation without any oncology.

Don't get me wrong, I truly hope Dr. Halligan chooses to work within the system we have and that whomever is better, he, Dr. Chung or someone else provides the peninsula with great oncology care. Those who choose to participate without the oversight of the hospital should be left out, as that will result in poorer care for the majority of the citizens of the Kenai Peninsula.

Carver
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Carver 02/15/12 - 07:30 am
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Thanks . . .

Thanks, Hmmm, good comments. While I can understand the docs wanting their own business, I'm very disappointed that none of the physicians have responded to the question of whether or not they will be taking Medicare and Medicaid patients.

As for CPH, I think they need to get back to their core mission which is to provide a place for docs to work to the benefit or area residents. What business has CPH in becoming a vehicle of patronage to local entities such as the Watershed Forum, the Food Bank, and Kenai River Sportfishing Association?

Seems plain to me that we've a mess on our hands, some sort of competition for control of health care dollars, with charges and counter-charges flying from both sides. Whom and what is the public supposed to believe?

Are area docs really refusing new Medicare patients? Is that why CPH is buying up physician practices? Do these private ventures really want to skim the cream to the detriment of the hospital? Is CPH really wanting a health care monopoly? Is CPH really seeking to dictate to the docs? Are physicians really "greedy"?

Ain't much to see in a small town, but what one can hear sure makes up for it. I truly wish both sides would level with the public. What a mess!

Dr. John Halligan
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Dr. John Halligan 02/16/12 - 12:19 am
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I would like everyone on the

I would like everyone on the Kenai Peninsula to understand that we will take care of their radiation oncology needs regardless of their insurer (Medicare, Medicaid, Private or Charity) regardless of whether we are located across the street from or on the grounds of the hospital.

Carver
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Carver 02/16/12 - 06:45 am
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Thank you . . .

Thank you, Dr. Halligan, I would have expected no less. I am covered by Medicare, and Dr. Chung readily accepted me as a patient.

Now if we can only get other area docs to comment as well . . .

Henry Krull MD
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Henry Krull MD 02/17/12 - 12:19 am
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In response

Carver, I have followed these posts with keen interest, and made a conscious effort to not respond or get involved in the mud-slinging detailed above by our former hospital CEO,and current CPGH, Inc. board member. I do appreciate your comments and insight and feel compelled to respond to the question you have asked in posts about whether area physicians refuse to see Medicare patients. In my 13 years of practice in Soldotna, I have NEVER refused care or limited access to Medicare, Medicaid, VA, Denali Kid Care, self-pay, no-pay, or insured patients. As a member of Kahtnu Ventures, I and the rest of the surgeon-members of Kahtnu Ventures will continue to provide care for all patients regardless of insurance status or ability to pay, in our private offices, Central Peninsula Hospital, and in our proposed ambulatory sugery center. Declining reimbursement to physicians from Medicare over the last 5 years (including a proposed 27% cut in reimbursement that is to take place on March 1st, 2012), in particular, makes this challenging especially to primary care physicians. As a result, some primary care physicians have had to limit the number of new Medicare patients they see, but I am not aware of any physicians in the area who have refused to see Medicare patients.

Finally, I must add that I am appreciative and supportive of the efforts by Dr. Halligan and his colleagues to establish a much needed cancer treatment center on the Peninsula. It is unfortunate that this wonderful and long-awaited opportunity has been met with harsh criticism, and baseless accusations regarding his intentions, motives, and methods. When Dr. Halligan announced his proposal a one-word answer from the community at large would have sufficed: THANKS.
H Krull

Carver
1106
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Carver 02/17/12 - 08:53 am
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Mud-slinging . .

". . the mud-slinging detailed above by our former hospital CEO, and current CPGH, Inc. board member."
********************

Such tactics and attitude are deplorable and yet one more reason why the CPGH Inc. board needs to become an elected position, answerable to the public it purports to serve. As it stands now, CPGH Inc. members can make such slanderous comments free of accountability to no one except themselves.

Can anyone honestly imagine such vitriol coming from an elected board member of Homer Electric?

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