Published Friday, March 26, 1999 |
The competition Sharon Regional has identified the following organizations as being competitive:
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"They're trying to force you to pick a side,'' Panariello said. "I refuse to pick a side. I won't pick a side. I took an oath to take care of my patients. The hospitals can be a part of that relationship or not.''
He and other some physicians in the county are seething at both SRHS and Horizon because of recent actions taken by both local health care providers.
In January SRHS enacted a policy, effective Feb. 1, that states if a physician has a leadership post or an investment in certain competing health care providers, their status at the Sharon hospital will be reduced from active to affiliate. However, on Wednesday the hospital modified that policy to exclude private practice physicians.
An active physician at the hospital is allowed to practice there and vote at medical meetings where policy issues are debated, such as business affairs and staffing. Under an affiliate status a physician can still practice at the hospital but is barred from the meetings.
Wayne Johnston, president and chief executive officer of SRHS, said the measure was designed as a conflict of interest policy.
"It doesn't affect the number of patients they can see or what they can do,'' Johnston said. "It centers on who can be involved in the direction of the medical staff.''
A number of physicians expressed concern that if they were reduced to an affiliate status and they decided to bring a partner into their practice, that new physician may not be able to practice at SRHS.
But Johnston said that isn't the case. Partners of affiliate doctors would be able to practice at the hospital, he said.
Conflict of interest policies are common in the hospital industry, he said, adding that no physician has lost the right to practice at the Sharon hospital.
SRHS's action was taken in part because of the growing competition in the hospital industry, Johnston said.
"With managed care reducing payments, Medicare reducing payments ... if we sat and did nothing the hospital could begin to have significant problems and the resources wouldn't be there to take care of patients locally.''
On Wednesday SRHS changed the rule adopted on Feb. 1 so private practice physicians no longer fall under the policy, Johnston said.
That would mean that physicians such as Panariello could bring on partners who could practice at Sharon Regional.
J. Larry Heinike, president and chief executive officer at Horizon, criticized Sharon Regional's policy.
"It is a policy that curtails physicians' freedom of choice and curtails patients' freedom of choice,'' Heinike said. "It forces physicians into choosing a hospital and into a relationship they may not want to be forced into. It precludes physicians who might want to come to this community from having choices they might like to have.''
Horizon has no policy similar to SRHS's nor plans to enact one, Heinike said.
Johnston staunchly denied the policy stymies choice among patients or physicians.
"This has no impact on the patient,'' Johnston said. "Physicians still have the freedom to make their choice.''
Heinike isn't the one who should be pointing fingers, said Dr. Joseph Morelli, a private practice physician and president of the Mercer County Medical Society.
"It is the opinion of the medical society that the situation at Horizon is worse,'' Morelli said. Morelli treats patients at Horizon but not Sharon.
Earlier this month Horizon revoked Dr. Patrick Shaughnessy's privilege to treat patients at the hospital system, Morelli said. Horizon took the action because the doctor left a medical practice to join one with privileges at SRHS, he said.
"He was thrown out at Horizon based on an economic decision,'' Morelli said. "There was no clinical basis for this at all.''
Shaughnessy would only comment to say that Morelli's description was accurate.
As a result, at a recent meeting the local medical society unanimously voted to send a letter seeking legal, financial as well as political support for Shaughnessy from the Pennsylvania Medical Society and the American Medical Association, Morelli said.
"This hits very close to home,'' Morelli said. "You begin to wonder, 'Can this happen to me?' ''
Heinike said he wouldn't get into the nitty-gritty details, but said the circumstances surrounding Shaughnessy has nothing to do with who he is practicing with. What's more, there's no way that the situation with Shaughnessy can be compared to Sharon Regional's policy, he added.
Horizon accepted bids for services from specialists in physical medicine and rehabilitation. Shaughnessy did not submit a bid for those services, Heinike said.
Shaughnessy was a contract physician whose contract had expired, Heinike said. A contract physician has a written contract with a hospital to perform certain services. A private practice physician is self-employed. Such physicians may be credentialed by a hospital to perform certain functions but do not have contracts.
"This is not a global issue. This is an isolated specific issue related to a specific contract for physical medicine and rehabilitation,'' Heinike said. "This is purely a one-doctor issue. I believe Morelli, through the medical society, doesn't like exclusive contracting.''
In looking at SRHS, Morelli said the hospital's decision to change the policy Wednesday made it more palatable.
"If they excluded private practice physicians that makes it more reasonable,'' he said.
Still, Panariello said he's fed up with the bickering and sniping between the two health care providers and their top administrators.
"It's a high school football mentality of whoever is with us is with us and whoever isn't is against us,'' Panariello said. "I think this is another chapter in the ongoing personal war between Mr. Heinike and Mr. Johnston. It's sad that two men can interfere with health care this much. Is all of this really good for the community?''
Both Heinike and Johnston said the decisions they make are in the best interest of the hospitals and the communities they serve.
"This has nothing to do with Larry Heinike,'' Heinike said.
Johnston noted that health care has changed over the years and administrators have to look out for what is in the best interest of their hospital and the community they serve.
"There are a few people who want to be able to play both ends against the middle,'' Johnston said. "This is the environment we're in and we have to deal with it.''
