HEART-TREATMENT EQUIPMENT
Riverside, OSU now spar over technology
Monday, December 18, 2006
Suzanne Hoholik
<The fight for getting STXS Niobe is interesting :-)>
Not only did Ohio State hire five specialized heart doctors who used to work at Riverside Methodist Hospital, it also signed a deal to buy an unusual catheter and made sure that Riverside can’t buy one of its own for at least a year.
The exclusive contract is the latest shot fired in the war between OSU Medical Center and Riverside over patients, prestige and money.
Ohio State wants to make its heart program one of the top 10 in the country. For four years, it has been hiring physicians, teachers and staff members with that in mind.
Up the road at Riverside, officials say OSU is building its heart program at their expense and hurting patient care with some of its tactics.
"I think anytime there is a business decision that knowingly prevents a segment of the community access to a technology like this, that is wrong," said Bruce Hagen, president of Riverside.
But any patient willing to switch doctors and hospitals could go to Ohio State to take advantage of the catheter technology.
Hagen said the five doctors Ohio State hired were supposed to help bring that technology to Riverside.
Ohio State said Riverside had its chance.
"This was available to anybody in the community," said Dr. Fred Sanfilippo, chief executive of OSU Medical Center. "If OhioHealth (Riverside’s parent company) wanted this, they simply could have purchased it."
Patients with irregular heartbeats can be treated with the new catheter at Ohio State by early March. Right now, the closest hospital to offer the Stereotaxis heart treatment is the Cleveland Clinic.
The technology uses magnets to guide a catheter to parts of the heart previously unreachable in patients who suffer with atrial fibrillation.
When Ohio State paid $3.4 million for a Stereotaxis Niobe II system in September, the St. Louis company that makes it agreed not to install another machine within 30 miles of OSU for at least a year. If the university buys a second machine, the exclusivity clause is extended another year.
Hagen said if Riverside had purchased the equipment first, it wouldn’t have demanded exclusivity. At one point, Riverside was the only hospital to offer lithotripsy — shock waves to reduce kidney stones— but didn’t sign an exclusivity contract.
Sanfilippo, though, said such exclusivity agreements are common with scientific and clinical equipment. In 1998, OSU had an exclusive agreement for use of the gamma knife, a radiation tool that zaps brain tumors.
Because the heart catheterization machine is so expensive, he said, this clause ensures that the university will get its investment back.
In most catheterizations, physicians must guide catheters by hand. The Niobe II allows them to use computers to guide the probe.
"The real brilliance behind this magnet is it can make turns and reach places in the heart that just aren’t possible with caths on the market," said Jim Tomaszewski, vice president of Riverside’s heart services.
Both hospitals say they had planned to buy the equipment for at least two years.
But Hagen said the five electrophysiologists who left for Ohio State slowed the process.
Dr. Emile Daoud, one of the five physicians, said that’s not true.
"They (Riverside officials) were slow to do anything," he said. "It’s completely inaccurate to say we slowed them down."
Daoud and the others — Drs. John Hummel, Ralph Augostini, Steven Kalbfleisch and Raul Weiss — left Riverside and their private practice, Mid-Ohio Cardiology and Vascular Consultants, last month. The doctors have never been employed by Riverside, but they worked there.
Along with the Stereotaxis machine, OSU offered the doctors what they wanted: staff physician spots, faculty positions, a fellowship program to groom new electrophysiologists, and research opportunities.
Hagen said the five doctors asked Riverside for the same things in August as well as individual compensation packages of more than $1 million.
He said he hired a consultant to determine what the doctors were worth to Riverside. The consultant came up with two options, the lower of which outlined a $925,000-per-physician package.
Hagen thought the doctors wouldn’t accept this and in an Aug. 20 letter to them, he outlined a counteroffer that included no money.
The physicians left.
Ohio State is paying each of the doctors base salaries of $650,000 as well as a deferred salary of $250,000 a year for five years, according to records released by the university.
Mid-Ohio Cardiology has hired three doctors who will practice at Riverside, but the hospital said recruiting has been hindered without the new catheter machine.
Hagen said Ohio State should waive its exclusivity clause with Stereotaxis so Riverside can buy its own.
The boards of the Richard M. Ross Heart Hospital and OSU Medical Center discussed doing this at recent meetings, but no decision was made.
In the meantime, OhioHealth, which operates Riverside, has sued an employee it says provided secret information to the five doctors about the hospital’s electrophysiology program.
The employee, Scott T. Simmons, a computer analyst and former nurse, pleaded guilty in 2000 to one count of theft for stealing medications from patients while working at Grant Medical Center, also owned by OhioHealth.
He lost his job and his nursing license.
At some point, Riverside hired Simmons, who declined to comment.
The battle among hospitals for specialists and technology is not new, experts said.
Both are about increasing patient volume, said Dr. Robert Berenson, a senior fellow at the Urban Institute. And heart services, he said, are among the most lucrative for hospitals.
Berenson co-wrote a recent study that included comments from hospital executives who said any profits they had were because of the heart services.
"So, it generally has been that important," Berenson said.
All three adult hospital systems in Columbus advertise their heart programs.
Riverside is the only central Ohio hospital ranked by U.S. News & World Report for a heart program. The hospital advertises its ranking — 46 th in the nation — on a billboard on Rt. 315.
OSU Medical Center was ranked by the magazine in several categories, but not for heart services.
Sanfilippo said he wants every OSU program to make the magazine’s list "because it is a popularity contest."
Dr. Hoangmai Pham, a senior health researcher at the Center for Studying Health System Change, said there are much more important data that hospitals could advertise, but, "Those measures aren’t on the radar of consumers as U.S. News & World Report is." |
