Jason Sandford
Jason Sandford is a reporter, writer, blogger and photographer interested in all things Asheville.
This is a big development in the ongoing debate over what’s happening at Mission Hospitals. Some local physicians have expressed concerns about physician-hospital relations, and the hospital has put together a blue-ribbon committee to examine the issues. Go here and here to read some of the background. At the bottom of this post, you can click the tag “Mission Hospitals” to read everything that’s been posted.
Here’s the tip I’ve recevied. Further confirmation/comments are encouraged
A large local medical practice has decided to sell out to Mission: Asheville Cardiology Associates. They are not planning to officially announce this until some time in October with the effective date of the sale being January 2010. This will likely be a setback for health care in Asheville…reducing an already limited choice by further monopolizing health care in the Asheville area. Asheville Cardiology is the only cardiology care provider in Asheville. (Asheville Cardiovascular is a practice of heart surgeons…a different sub-specially than clinical cardiology.) There are a couple hospital-based cardiologists at Park Ridge in Fletcher and another two or three doctors in an office in Clyde. Asheville Cardiology already has branch offices in Hendersonville, Brevard and Franklin.
ACA has competed with Mission in some respects with their diagnostic imaging services, but with the buy-out, there will be less or, in some cases, zero competition. ACA was “allowed” a Certificate of Need for their outpatient catheterization lab, only because Asheville Cardiology agreed to let Mission in as a partner in the venture. Otherwise, Mission would have formally objected to any Certificate of Need being issued. (For certain health care services/equipment, a Certificate of Need must be obtained from the state. This is more or less the convoluted way that the “big hospital” lobby keeps competition out so that they can continue to rake in large profits. They spend money electing and lobbying officials to convince them that certificates of need are based on quality to shield the fact that its about profit.
Since the federal government agreed to let Mission and St. Joseph’s merge, and after the 5 year COPA agreement expired, “seize and conquer” has been the mantra at Mission.
Anyway, I think a lot of doctors in the area will be surprised and take it as a serious blow that a multi-million doctor practice like ACA is feeding into the fear of the unknown and selling out.
Yep, the "Optimistic RN" administrative plant rears its ugly head again.
if this merger is allowed then seriously consider seeking your health care outside of the Mission system…if you need a cardiologist you will be better served in Charlotte, Atlanta or Winston Salem…ANYWHERE but here! This merger will not be in the best interest of the patient. It will increase patient cost. These doctors at ACA are selling out big time and also, what about all their employees? They just built that pretty new office and now they can’t operate as a business? Follow the money…this system of hospital/physician merger has been tried in Roanoke VA and ask around that town if it is good for the consumer. Change is coming to Asheville and it will not promote compassion for the patient! Watch out, the standards in quality care for patients is leaving town…and you will pay for Joe’s big business
Asheville has such a fantastic healthcare community with top notch physicians and a hospital rated one of the best in the country. It is very disappointing that a few vocal physicians and a few unhappy employees are getting so much attention. Truth is they are concerned that the groups who are being proactive and joining with the hospital to provide more coordinated and cost effective care will be at an advantage. And they are absolutely right……… Hats off to ACA and others who are negotiating with Mission. They are joining hundreds of other large and small practices across the county who are planning ahead to help protect and stabilize a practice they have worked so hard to build. Mission has worked hard to provide the newest technology for the physicians to use in order to provide state of the art care. They have maintained excellent RN staffing. Patient outcomes at Misison are excellent due to top notch physicians, nurses and other members of the healthcare team. There has to be a symbiotic relationship. Physicians and Mission are dependent on each other.
We all need to keep focused on what’s best for the patients vs our individual wants and needs.
Many of the comments have focused around Joe’s need to control but personally I think some of the dissatisfied physicians are worried they are losing control of their practices/market share because other groups are chosing to work with the hospital. With the economy and changes in reimbursement it makes much more sense to work together. Mission is not the problem. Reimbursement tightening and uncertainty is. Kudos to the groups who recognize this and are willing to work proactively for a solution to benefit their practice, employees, the hospital and most importantly the patients.
I’m no fan of JD, as a matter of fact, i think he was a bad choice from day one. Not sure one person could screw up things as much as he has if they tried. That said, I do think that the hospital (with appropriate leadership) and ACA working under one entity is the right thing to do. Look around the country and you’ll find the best heart centers in the country are together not two seperate entities. Look at the top hospitals in America and all of them have an intergrated model with physicians and not just with cardiologist.
If Mission wants to get back to being a top tier hospital they need to get someone at the CEO level who can work constructively with the medical staff and the conmmunity. That ain’t Damore. He has too much ego, is a total control freak, trust no one but god (Just ask him) and has zero self awareness. He thinks he is perfect. If Damore had on ounce of honor in him, he would resging and allow the rebuiling of the medical community to begin. Don’t bet on that happen because his ego would never allow him to admit he needs to do that. It’s all about Joe in Joe’s mind. !
It seems convenient that when ACA was approached by the hospital for the buy out of their cath lab, a certain member of ACA was "coincidentally" made vice chief of staff. Close neighbors in more ways than one (Mr. Aston). This was a premeditated move to keep the doctors in line. The timing is quite suspect.
Refreshing to see the Citizen Times, evidenced by the Cohen cartoon, finally shed true light on what is transpiring at Mission. To use a southern colloquialism, board and blue ribbon panel: Git R’ Done!!!!
Mission Impossible
If ACA and the ACA staff dont see the handwriting on the wall from the history of MMH and the management of JD then you deserve what you get. Sell out and budget tightening are the key words here. More work less employees,constraint on hiring new physicians as needed are all in the future.The "Blue Ribbon" Panel will fall by the wayside and MMH will be on the way to the goals of a monopolistic pseudo giant which was the goal of the folks on the "Board" that recruited JD here in the first place.Its all falling into place.The great autonomous medical community that made Asheville an ideal place to practice over the years with physician cooperation,nurses that knew what was going on from experience,great patient care is rapidly circling the drain.WIll be interesting to see how all this evolves.I firmly suspect Blue Ribbon Panel and the Board will fold like a cheap suit.
FYI: Mission had subsequently purchased the Cath Lab from ACA sometime, i believe, earlier this year or late last year. Part of the same MSJ snap-em-up plan, i guess.
As an employee of Asheville Cardiology, i know that the ACA docs are fiercely dedicated to their staff and saw writing on the wall of facing some pretty severe cuts based on the shape of the economy and changes in medicare and other payments in the future. The docs may be planning their own futures and trying to get a buyout with a good deal, but they also knew that if they did nothing that there were going to be strong belt-tightening and possible layoffs of staff. Certainly there were going to be deep cuts in what they could offer in benefits packages and other compensations. Management has been prominently re-assuring employees that we will all continue with our jobs, but with any change, those affected by these decisions are naturally nervous.
But what i see – and i may be all rosy-eyed – is an opportunity to continue as close to what we have been in the future. My feeling is that MSJ doesn’t want to muddle with the management of what has already been a profitable venture, just a slice of the (financial) action. Yes, Mission will undoubtedly find strong ways to benefit from the monopoly they’re buying into, but this is most probably the first or almost first of many practice buyouts. Better for ACA to be first and strongest in helping to forge some balance between ownership and independence.
I still see Mission as greedy and controlling, but their history shows some inexperience in best managing what they have.
Have the docs been worried or affected by the controversy of problems between Mission management and doctors? You bet, and that has affected negotiations. I still think that ACA may be smart in recognizing the inevitable and becoming an early pioneer of the process.