Voices of the Peninsula: LHP promises don't match CPH needs

Posted: Thursday, September 02, 2010

I oppose our hospital partnering with LHP, an investor-owned hospital group. I believe a for-profit partner will increase healthcare costs and may compromise quality. My vision is to provide exceptional care, efficiently for the residents of the Central Peninsula. We don't need LHP capital or expertise at present or in the future.

It would appear that our hospital administration and a majority of board members have a vision of continuing to enlarge our hospital. In press releases and newspaper articles they talk about expanded cardiac services, (i.e. a catheterization lab), a cancer treatment center and a medical office building. These would require capital and perhaps expertise in hospital administration that we don't currently have. They talk about being part of something bigger to weather the changes coming to healthcare.

I want us to provide exceptional care in a cost efficient manner to the residents of the Central Peninsula for years to come. With our recent expansion we have a beautiful hospital facility. We are a regional medical center providing a wide range of services. We have accomplished this despite a so-called antiquated governing structure and no outside capital. Expanding services to meet the needs of our community is ongoing. This should be done wisely, consciously and with the goal of improving care. This may require capital that can be obtained through profits from the hospital or municipal financing.

Let's look at the list of items being promised by LHP. Many cardiac services are already available including: stress testing (with and without nuclear imaging), echocardiograms and visiting Cardiologists for consults. A cardiac catheterization lab has been mentioned, but I assume it would only be diagnostic, as back-up cardiovascular surgery needs to be available if doing angioplasty or a stent. If a patient is having a heart attack, they will likely need a procedure, so they would still need to be transferred to Anchorage. If there is a high suspicion of a blockage in a heart artery, it makes sense to do one intervention, both diagnostic and procedure at the same time. So even though a cardiac catheterization lab sounds great, realistically it might save only a few people a trip up the road. In the current payer system it is lucrative to perform catheterizations and I would worry more people than needed may end up with diagnostic catheterizations. That drives up costs and risk for complications.

A cancer center sounds nice. We do have an oncology/infusion center that administers chemotherapy and other IV medications on an outpatient basis. The hospital is working on getting Oncologists from Anchorage to come down for consults. The thing that would cost a lot and save many people travel would be radiation oncology services. I'm not sure we have the volume to support this and I've noticed LHP isn't making any promises there. Certainly, for long term cost control, we should be wise before investing money in expensive equipment. In addition to cost/benefit, quality is often affected by volume. If we don't do enough of specialty procedures then having qualified providers and staff to do high skill procedures is compromised. If we are going to provide a specialty service I feel strongly we should be doing it well.

A medical office building makes sense especially if the hospital continues to grow in owning and running of physician practices. At this point the office building I'm in (a short walk from the hospital) is only half full. At some point more space may be needed, but before building new space I believe we should know it would be full.

I suspect LHP is very good at being a partner to hospitals. Obviously they impressed our hospital board of bright, local, committed volunteers. Furthermore, they sound willing to commit to local control, physician involvement and community participation. However, we cannot forget that they are an investor owned, for-profit organization. When I did some research on such organizations I found that for-profit medical care companies are often more expensive. Furthermore, they are often of lower quality. In fact, other than a family-owned for-profit company called Prime Healthcare in California, no other for-profit companies broke the top 20 percent in quality rankings in the 2010 Thomson Reuters review of health systems. A Thomson Reuter research brief titled "Differences in Health System Quality Performance by Ownership" (dated August 9, 2010) showed investor-owned systems had the lowest performance in multiple quality categories. High cost and poor quality do not fit my vision.

Our nationwide dysfunctional system of financing healthcare has to change. When I review healthcare financing reform from legitimate sources it all focuses on support for high quality efficient programs. Now that fits my vision. If we focus on providing exceptional care for all ages, providing preventive and acute services for all of the residents of the central peninsula in a compassionate, cost minded way, then we will be preparing for the changes coming to healthcare.

At present, we have an exceptional facility with committed well-trained staff, providing many services and we can add more with wise strategic planning to meet our community needs in the future. I recently cared for a gentleman from Texas who felt the care he had at our hospital was outstanding. He said his experience at CPH was superior compared to the three similar sized hospitals he had within 100 miles of his home. I believe my vision is clear. The mission of our hospital is to provide exceptional care to the people who live and visit here and be a positive employee and community presence. We can do that best by keeping local ownership and governance. As far as weathering changes I guess I trust our local government and the residents of the Peninsula more than eleven Texas capitalists.

Dr. Katy Sheridan, MD has been a family doctor in Soldotna for the last fourteen years. She was born in Soldotna, grew up on a homestead in Kasilof, attended college in Portland, Ore., medical school as an Alaska WAMI student through the University of Washington and completed a three-year family medicine residency in Maine. She is passionate about her chosen profession and hopes to live among and provide healthcare to the residents of her hometown for years to come.

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