After more than a year of preparation, David Morehead, M.D., and Carl Berasi, D.O., are about to face off against each other in a battle between an existing group of acute care hospitals and a new physician-owned specialty hospital.
Neither of them seems ready to blink.
Morehead is chief medical officer of OhioHealth, which runs three hospitals in the Columbus, Ohio area.
Berasi is chairman of the board of a new orthopedics hospital, New Albany Surgical Hospital, in New Albany, a Columbus suburb.
The 42-bed specialty hospital, 60% owned by local physicians and 40% owned by Surgical Alliance, Nashville, held a ribbon-cutting ceremony Nov. 23 and was expected to treat its first patient Dec. 1.
Back in 2002, in reaction to initial planning for the new orthopedic hospital, the board of directors of OhioHealth ruled that after the facility opens, physicians investing in it will lose their privileges at all three OhioHealth hospitals.
To accomplish that, Morehead says, physicians who are thought to be New Albany investors "will be asked to inform OhioHealth that they are, in fact, investors." He says those who say yes will be expected to "voluntarily" relinquish their privileges; if they do not, they will be required to relinquish them.
The OhioHealth policy is the strongest in the country against the growth of specialty hospitals, and both sides in the nationwide debate on this trend are nervously waiting to see how it turns out.
"This may seem like a punitive measure, but it is really a conflict-of-interest situation," Morehead says. "We're in the midst of a social debate on the best way to provide healthcare."
The imposing New Albany facility, with 96,000 square feet of space and eight operating rooms, does not provide many services found in a community hospital, such as obstetrics or an emergency room.
By focusing on moneymaking services such as orthopedics, "the specialty hospital really does take a lot of the profit out of the full-service hospital," Morehead says.
Berasi laid out his case in an opinion piece in this month's issue of Columbus CEO.
"While community hospitals are the department stores of medicine and expected to be 'jacks of all trades,' specialty hospitals are 'focused factories' that do one thing and do it very well," he writes.
His piece adds that the facility should be judged on its own merits. "If we fail to provide better quality of care for their patients," he writes, "the patients will not come, and the hospital will fail."
Berasi and his partners are not making it easy for OhioHealth to carry out its policy. Thirty doctors have identified themselves as "founders" of the new facility, but not necessarily investors.
Berasi says he has talked to an attorney about the possibility of suing the hospital, but "we'll have to wait and see."