LAWRENCEVILLE -- Last month, Eastside Medical Center announced plans to begin offering angioplasty and other cardiac services, an advancement made possible through a partnership with Atlanta's Piedmont Heart Institute.
On the surface, the deal seems like a positive one for Gwinnett -- but two local cardiologists don't see it that way. One called it "the height of hypocrisy." The other simply dubbed it "ridiculous."
Both surmised that the bottom line in the decision was, in fact, the bottom line.
"This is not the right thing to do, and that's my take on it," said Dr. Lanny Lesser, who's practiced in Gwinnett since becoming the county's first board-certified cardiologist in 1979. "It's not a personal anger. I'm annoyed at the way business takes precedence over everything else."
About two weeks ago, Eastside announced its plans to start offering cardiac angioplasty (a procedure called percutaneous coronary intervention, or PCI) at its Snellville campus. The deal will grant all cardiac procedures exclusively to Piedmont Heart Institute physicians.
Once the arrangement is finalized on or around May 1, that means physicians from local organizations like Lesser's CardioVascular Group and Gwinnett Consultants in Cardiology -- many of whom have been practicing in the county for decades -- will be shut out.
Lesser and Dr. Manfred Sandler (another cardiologist and the physician who fought hardest to bring open heart surgery to Gwinnett Medical Center) are concerned about what that means for patients.
"A patient of the existing three groups who presents to Eastside's emergency room will have no choice but to be assigned to a new cardiologist," said Lesser, a longtime friend of Eastside and the co-founder of the Gwinnett Community Clinic. "An existing cardiac patient undergoing surgery will not have his cardiologist available for consultation ... Continuity of care will be disrupted at a crucial time in the patient's medical history."
Said Sandler: "The decision that Eastside and (parent company Hospital Corporation of America) have made is clearly wrong for patient care and for Gwinnett County citizens. There's no doubt about it in my mind."
In a statement attributed to CEO Kim Ryan, Eastside said its board of trustees determined that an exclusivity agreement was "the most appropriate action" in order to "ensure the high quality and efficient operation of the service."
"We first approached the cardiologists on our medical staff four years ago and asked for their assistance to offer this new service," the statement said. "After years of discussion, they declined to support this effort. As a result, Eastside had no choice but to look elsewhere."
The bigger question, perhaps, is why are extended cardiac services coming to Eastside?
Even with Gwinnett Medical Center about eight miles away, Eastside officials cited a "growing need" for comprehensive cardiac care in the county.
"Upon implementation of the new PCI program in May," Ryan's statement said, "citizens of Gwinnett and the surrounding communities will benefit from having life-saving PCI procedures and a strengthened cardiology program close to home at Eastside Medical Center."
The effects of competition on medical care have long been debated. Some believe it leads to better care and lower costs. Others believe just the opposite -- competition, particularly in cardiac care, can lead to unnecessary procedures and increased costs, a product of a patient base spread thin and a struggle to keep specialized offerings economically viable.
Lesser and Sandler fall in the latter camp, and believe Eastside's transition is nothing short of a money grab.
"I think it's unconscionable to be so concerned about the bottom line," Lesser said. "HCA did not want Eastside to lose market share of PCI."
HCA, Eastside's parent company, is a national corporation based in Nashville, Tenn., that owns 163 hospitals and 109 surgery centers, according to its website.
Lesser's assumption is also based partly on the fact that Piedmont was one of three Atlanta hospitals to file formal opposition when GMC applied for approval to begin building its own open heart program.
Along with Emory University and Emory Crawford Long hospitals, Piedmont tried twice to block GMC's push for a program with state regulators, citing, among other reasons, that "hospitals need to perform a high number of procedures to maintain quality."
"These are people that, from a financial point of view, didn't want anything to happen in Gwinnett County," Sandler said. "And now they're going to send people out of the county again."
"We don't mind competing," he continued. "Any day of the week. But to give someone exclusive rights just because your don't want more work to go to Gwinnett Medical Center? That's ridiculous."
A statement released to the Daily Post by officials from Piedmont did not address specific questions, but reiterated what they believe their services will bring to the county.
"Residents of Gwinnett and the surrounding communities will benefit from having access to round-the-clock cardiac care close to home, including live-saving angioplasty," the statement said.