Roanoke, Va.-based Carilion Clinics reorganization plan is meeting
stiff opposition from area independent physicians.
The newly formed Coalition for Responsible Healthcare, which represents roughly 200 Roanoke-area physicians, aired concerns with the seven-hospital systems restructuring plans during a recent public hearing. In June, Carilion Health System announced plans to convert from a health system to a physician-led clinic; expand its Roanoke campus; hire specialists and subspecialists; and launch a research partnership with nearby Virginia Polytechnic Institute and State University (June 26, p. 6).
Geoffrey Harter, a physician with Roanoke Ear, Nose and Throat Clinic and the coalitions president, said the coalition fears Carilions plans to employ doctors will squeeze out independent physicians, alienate patients from longtime providers and give the clinic a monopoly hold on Roanokes healthcare market. Carilions 1990 merger of two not-for-profit Roanoke hospitals was the first such healthcare deal ever challenged by the Justice Department. The system succeeded after a two-year court battle.
The coalition also challenged the clinics plans to spend $100 million on its conversion, he said, which is money that might be better spent on upgrading Carilions hospitals.
Harter said the coalition extended an invitation to Carilion officials to attend the public hearing. Mark Werner, Carilions chief medical officer and executive vice president, denied executives received an offer to attend the two-hour meeting, but said he welcomes discussion with the doctors. I dont have any heartburn over there being a coalition, Werner said. Were delighted that physicians want more information. Were delighted that they want to engage in thoughtful conversation about improving the quality and efficiency of medical care. Its not yet as good as it can get, he said.
The clinic has held two two-hour community forums that attracted an estimated 90 people each, a Carilion spokesman said. Four more are scheduled.
Harter said independent doctors want to be represented on the clinics governing board. Independent physicianswhose practices and patients will be affected by Carilions conversionwere not consulted as health system executives drafted their plans, he said.
Carilion officials have vowed to keep the clinics medical staff open and are considering how to collaborate with private practices, Werner said. The clinic wont encroach on the responsibilities, accountability and authority of Carilions medical staff, but officials will stress that those responsibilities include quality improvement efforts such as evidence-based medicine.