Patients wonder: Where did my doctor go?
Departure of 27 cardiologists left folks asking, but Orlando Health says it followed practice
When Orlando Health told Andrew Gasparovic his cardiologist was leaving, he asked where the doctor was going.
Staff would tell him only that his doctor was departing Oct. 1, and that he could switch to a new doctor within the system or take his medical records and transfer to a doctor outside the system.
Gasparovic said he talked to multiple Orlando Health employees, seeking context. Did his doctor retire? Did he die? Did he move to another state? Did he leave contact information?
Gasparovic, 88, says the answers he received were inconsistent. Finally, an Orlando Health staff member told him over the phone they were instructed to say they didn’t know, he said.
As it turns out, Gasparovic’s doctor was working right down the street from Orlando Health’s main cardiology office and still had medical privileges at Orlando Health hospitals. He was one of 27 cardiologists previously employed by Orlando Health Heart and Vascular Institute who, in October, left to form the Cardiovascular Center of Florida. The new practice was established by Cardiovascular Associates of America, which was formed by private equity firm Webster Equity Partners.
This mass exodus of doctors has spawned multiple lawsuits, angered patients and ignited an ethical debate about what hospitals and doctors are obligated to do when a doctor leaves a health system. Everyone agrees the transition could have gone more smoothly for patients, but they disagree on who is at fault, what could have been done differently and what the best outcome for patients looks like.
The cardiologists who left say they met and possibly exceeded
the industry standard for communicating their plans, giving several months’ notice and providing Orlando Health with their new contact information and office locations. They estimate they have about 50,000 active patients between them. Orlando Health sent a letter to these patients informing them their doctors were gone but not where they went.
But Gasparovic said that Orlando Health’s messaging initially gave him the false impression that his only option was to choose a new doctor. For patients determined to stay with their doctor, denying them information wastes time and causes stress, he said.
“The patient-doctor relationship is sacred,” Gasparovic said. “You have no right to deny me my doctor.”
‘That’s not our job’: It’s long been industry practice for medical groups, private-practice groups and health care systems not to give patients their old doctor’s new information upon their departure, or say why the physician left.
“That’s just the way it’s done universally, throughout the United States,” said Dr. Jamal Hakim, chief physician officer of Orlando Health. “That’s not our job.”
Information and location of the doctors who left Orlando Health for the Cardiovascular Center of Florida can be found by going to cardiovascularcenter.com.
“There is no physician in the United States that you can’t open a computer, Google their name and find out where they’re practicing,” added Dr. Aurelio Duran, a cardiologist who chose to stay with the Orlando Health Heart and Vascular Institute.
Rick Harrington, 55, of Tavares, said he was told by Orlando Health staff that his doctor retired.
“If you don’t know he is still a doctor and not retired, why would you Google him?” he said via text.
Harrington said he spent several hours on the phone and in person sorting out where his doctor was with Orlando Health staff before finding out he had moved to the new Cardiovascular Center of Florida practice.
Orlando Health’s Hakim contends it’s easier for patients to stay within a large health system that already has all their records than to leave with their doctor.
“Ethically,thebestthing for an elderly patient who may not be able to navigate well is just staying in the health system,” Hakim said. “So we’re trying to follow our moral compass here.”
But Dr. Adam Waldman, one of the cardiologists who joined the new Cardiovascular Center of Florida practice, said he has talked to patients who wanted to keep seeing him but struggled to figure out how. Patients are better served staying with a doctor who knows them personally, he argues.
“There’s a ton of patients who are upset, stressed and unduly put through this process,” Waldman said. “It’s really sad, and it’s really disheartening.”
That’s an issue the departing cardiologists could have helped handle, say some of the 51 doctors who stayed at Orlando Health.
Orlando Health Heart & Vascular Institute’s Dr. Muhammad S. Ghumman said it was the responsibility of the doctors who left to make sure their patients were taken care of.
“[The doctors] could have looked ahead and [thought], ‘I have patients scheduled for procedures; these are the phone numbers. I should take care of this before I leave, knowing there might be a gap of a month or two months, or however long until the services can be provided,’ ” Ghumman said.
The physicians who stayed behind have expanded their clinics and hours to take on the patients of those who left. And the Orlando Health system has hired 18 new cardiologists as of Wednesday to close the gap and intends to hire more, said Andy Shunk, assistant vice president at Orlando Health.
Shunk offered assurance that despite the confusion patient wait times for new appointments are the same now as they were before the physicians’ departure.
Ghumman said that since the doctors departed he has seen hundreds of their patients. He said he hasn’t heard any complaints.
“Not a single one of them is coming to my office, meeting me for the first time and saying ‘I’m only here because I couldn’t find out where my cardiologist went, and I didn’t have a choice,’ ” Ghumman said.
He, like many cardiologists at Orlando Health, was also approached to join the new practice but declined. He shared concerns that the new practice is owned by a private-equity firm, which he said could imperil patient health.
This is a debate that will remain relevant in the future as private-equity groups continue to buy up the health care sector, a trend that has accelerated over the past decade, according to a 2023 analysis published in BMJ, which also found that private equity was often associated with increased costs for patients.
Enter the lawsuits: Orlando Health and the Cardiovascular Associates of America are currently embroiled in a civil lawsuit in Orange County Circuit Court related to the 27 physicians who left, the hospital’s response and the impact it has had on both of their businesses.
In June Orlando Health and Orlando Health Medical Group filed a claim against Cardiovascular Associates of America, its CEO Cardiovascular Institute of Central Florida and several of the companies owned by Cardiovascular Associates of America. Orlando Health alleges, among other things, that the group encouraged some of the physicians who left to breach employment contracts and share trade-secret data, and that the establishment of this new practice is unfair business competition under Florida law.
The Cardiovascular Institute of Central Florida denied these allegations and filed a counterclaim in late October alleging Orlando Health engaged in deceptive trade practices by not telling patients the whereabouts of their physician.