After being denied a certificate of need to build an ambulatory surgery center, 10 physicians in rural DeKalb County, Tenn., population 17,423, say they will pursue their case in federal court if the Catholic parent company of the local hospital does not sell the facility.
The doctors say it was the interference of religious doctrine in medical practice-not financial or other issues-that drove them to seek the CON for a $1.5 million center where they could provide sterilization services.
"It's not business, it's just the fact that the Catholic Church has come into a small community and taken away a service we've always had," says Hugh Don Cripps, M.D., who represents the doctors.
The physicians contend that when Saint Thomas Hospital Health Services acquired 71-bed Baptist DeKalb in January 2002, it assured doctors and government executives that no services would change. The parent company of Saint Thomas is Ascension Health, a $9 billion Catholic system based in St. Louis.
Cripps says that physicians at Baptist DeKalb, in the county seat of Smithville, were told in June 2002 that they could no longer perform tubal ligations or other sterilizations, which had been provided since 1969.
Patients now must travel 40 miles to obtain them.
Saint Thomas spokesperson Rebecca Crimer says it was well-known that Saint Thomas, as a Catholic institution, does not provide tubal ligations because of the ethical and religious directives for Catholic healthcare.
The doctors insist they were misled, doubly so when Saint Thomas last winter entertained offers to buy the hospital, including one from the doctors for $15 million, only to announce on March 10 that it did not intend to sell.
At the CON hearing on April 23, Saint Thomas said it is again considering selling the hospital to an unnamed company that would allow sterilizations.
Cripps argues that because the purchase was funded with $350 million in municipal bonds, Saint Thomas could be crossing legal lines separating church and state. He says the physicians may take Saint Thomas to federal court to force an injunction under the 14th amendment, which ensures equal protection under the Constitution.
"We're licensed to do (sterilizations), and they take federal dollars," Cripps says. "I don't think they have a legal right to tell us what we can and can't do."