Board members of an acute-care hospital in Coeur d'Alene, Idaho, appear prepared for an economic credentialing fight with physician-owners of a competing surgical hospital about three miles away, making it the second such showdown in the state.
Meanwhile, leaders of the 21-bed Northwest Specialty Hospital in Post Falls, Idaho, are taking a wait-and-see attitude about the policy of their 316-bed competitor, county-owned Kootenai Medical Center, according to Northwest CEO Nick Genna.
Last week, board members at Eastern Idaho Regional Medical Center in Idaho Falls withdrew privileges from five physicians, including four owners of the neighboring 20-bed, physician-owned Mountain View Hospital. The revocation will be effective March 1.
In Coeur d'Alene, authorities at Kootenai Medical Center put in place a credentialing policy similar in many respects to that of EIRMC, according to a description of the policy by Kootenai board chairman and general surgeon Jim Curtis, M.D. The major difference is the Kootenai policy does not require physicians already on staff to disclose any interest in a competitor, but Curtis said new physicians seeking privileges will be required to make such disclosure.
Curtis said the policy was created in direct response to the advent of the specialty hospital.
EIRMC officials said they pulled privileges from the five competing physicians after performing an analysis of a year's worth of admissions data.
Curtis said the Kootenai officials have not crushed numbers on physicians working at Northwest Specialty Hospital, which opened in October. Asked if they would, Curtis said, "I honestly don't know."
The Kootenai credentialing policy has six points, Curtis said:
- Physicians must maintain sufficient patient volume so that the hospital can continue to evaluate his or her medical competency.
- Physicians must continue to meet emergency room on-call responsibilities (Northwest does not have an emergency department).
- Physicians cannot redirect patients who present in the emergency room at Kootenai to another facility.
- Patients must be given a choice between facilities.
- Physicians must work cooperatively with patients and staff.
- Physicians must maintain roughly equal payer mixes of their patients at both facilities.
Genna said the board policy is likely to face legal challenge.
Genna said he attended a candidates' forum Friday at a meeting of the Pachyderm Club, a local Republican group, where Curtis, who was running for reelection to the hospital board, was asked about the credentialing policy.
"He (Curtis) said the KMC board was not going to go down the economic-credentialing path, that it was not good for the community," Genna said. "He said they had opened a new heart center, and it would more than make up for the revenue lost (to Northwest)."
A second board member at the forum was asked about his position on the issue and confirmed he shared Curtis' view, Genna said.
The election was Tuesday. Curtis was re-elected. "Now we'll see if he follows through," Genna said.
"I did not say that," Curtis said in a telephone interview today, referring to Genna's account of his statements. "Those comments did not come from me. We will follow the principles of our medical staff guidelines."
The policy remains in full force, according to Curtis, and its conditions "apply to every member of our staff. We put them in place back in May 2002 and we expect all physicians to abide by them."
The new multispecialty surgical hospital has four operating rooms and three procedure rooms. It replaced a 17-year-old, three-operating-room ambulatory surgery center, North Idaho Day Surgery and Laser Center in Coeur d?Alene.
The same 12 physicians who owned the ASC own a 50% interest in the new hospital, Genna said. The other 50% stake is owned by National Surgical Hospitals, a Chicago developer of surgical hospitals.