Doctor calls assertions of heart surgery disparities untrue

DEAR EDITOR:

As the senior cardiac surgeon in Rome for the past 33 years, I am disappointed and disturbed at Floyd Medical Center’s accusations that the heart-surgery program at Redmond has not served minority and indigent populations in our community equitably.

Floyd has requested approval to start a second openheart program in Rome. The initial application and the appeal of that decision were both turned down by the Georgia Department of Community Health, Office of Health Planning.

Floyd is now requesting signatures on a petition to help overturn that decision. One of the primary arguments they are presenting is that African-American and indigent patients in our region are currently underserved by the cardiac surgery program at Redmond.

The implication that anyone has ever been denied or discouraged from needed care by our surgical team is absolutely untrue.

Rome was already a regional center of advanced cardiac care when I came to town in 1986. I have been proud and grateful to see it expand and grow over the past 3 decades into a center of excellence for adult cardiac care that now includes state of the art heart valve procedures, complex angioplasty, coronary bypass, arrhythmia management and prolonged cardiac support procedures.

Rome is a regional center of excellence in heart care that is very rarely seen in community of our size. There is always some level of competition

OPINION between hospitals, cardiologists, surgeons, but I believe that our success has been largely due to an exceptional dedication to the overall program and to the shared vision of being a state-of-the-art heart center.

The suggestion by Floyd that there is, or has been, any intentional barrier to cardiac surgical care here is completely unjustified.

First, essentially all patients who come to a heart surgeon are referred by another physician, usually one of the medical cardiologists. We have always seen every patient sent to us and if an operation is indicated, have scheduled and carried it out. We have never turned away any patient because of inability to pay and certainly not for their race, religion, gender or any other reason.

Second, my surgical partners and I have always been on active medical staff at Floyd as well as at Redmond. We have provided consultations, inpatient management of our patients, elective and emergency surgical procedures (except for open-heart operations) at Floyd. We also have always provided 24 hour per day, 365 day per year emergency call at both hospitals.

Third, since we are the only regional provider of open-heart services in the region, we have always accepted referrals and transfers from primary physicians in the community, from emergency department physicians, and from all of the region’s hospitals including Gordon, Tanner, Cartersville as well as Floyd Medical Center.

Unless Redmond is full, or the patient requires some unusual level of care that we cannot provide, we do not turn down patients from any referring facility. I believe that over the years, the largest number of patients transferred to Redmond has come from Floyd.

Finally, Redmond hospital and its corporate partner, HCA, have never once questioned our acceptance of any patient or applied any pressure to restrict or deny care based on ability to pay or any other reason.

Like all hospital care, heart surgery is not free or cheap. That is true at Redmond, Floyd and to my knowledge, every hospital in our nation. The high cost of hospital care is an issue that affects everyone and is clearly a barrier to access for uninsured or underinsured patients. However, our regional cardiac care team has had a strong commitment to provide care to the entire community and in my view has largely succeeded.

Floyd Medical Center has every right to apply for an open-heart surgical program and has every right to request community support of their application. However, I find their current criticism of our existing surgical program to be misleading, inaccurate and personally offensive.

To date, I have avoided any public statements about Floyd Medical Center’s decision to open a second cardiac surgery program in Rome because I felt that there might be a perception that I am biased by my closer relationship at Redmond over the years.

Since I retired from active practice 3 months ago and no longer have any potential benefit either way, I feel less constrained and will say that I would be disappointed if Floyd does start a competing heart surgery program.

This is not because I favor one hospital over the other, but because I foresee that if the heart surgery volume is split between the two hospitals, it is unlikely to significantly increase the number of procedures, but would definitely require expensive duplication of equipment, personnel and facilities.

Moreover, it is increasingly hard to compete with the larger metropolitan centers for heart surgeons, experienced OR nurses, physician assistants, ICU nurses, cardiac anesthetists and other ancillary providers that are so important to a successful program. By splitting that expertise, I fear a falloff in quality that might eventually lead to loss of both programs.

Despite my concerns, my partners and I have always agreed that if Floyd obtains approval for their program, we will help with planning and will provide open heart surgery at Floyd as we have done at Redmond.

For full disclosure, I want to point out that I have been a member of the Redmond advisory board for many years and continue in that position now. It is an unpaid position and I have no financial interest in Redmond or the hospital Corporation of America.

Dan Goldfaden, MD Rome