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Local cardiologists question motives of Eastside's actions

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."

Another question

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.

Comments

donnaj 2 years, 8 months ago

This personally makes me feel better. I stopped going to Gwinnett doctors years ago when doctors at the ER at Eastside misdiagnosed my heel fracture which consequently caused me to have chronic pain for the rest of my life. Sub-par doctors in a sub-par community. And fading fast.

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Jan 2 years, 8 months ago

You should not condemn all Gwinnett doctors for your experience at Eastside. Consider the point of the article and compare the for profit Eastside with such non-profit hospitals as Gwinnett Medical Centers (located in Duluth and Lawrenceville). http://www.gwinnettmedicalcenter.org Gwinnett Medical Centers is listed among top 100 hospitals in the nation!

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NorcrossDot 2 years, 8 months ago

Most all non-profit hospitals make a profit, they just hide it by re-investing into the hospital for tax benefits.

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LEX2091 2 years, 8 months ago

I AGREE. GMC IS OUT FOR PROFIT JUST LIKE ANY OTHER CORPORATION. OTHERWISE, THE CARE WOULD BE FREE. HA!!HA!!

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lmlesser 2 years, 8 months ago

GMC invests its "profits" back into the hospital making it a better facility. For example, Its radiology capabilities far exceed Eastside's. There are no share holders clamoring for "return on their dollar." GMC has garned community support and generous philanthropy amongst our citizenry. It was just voted one of the 100 best hospitals in USA. It deserves our support. Lanny Lesser, MD

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NorcrossDot 2 years, 8 months ago

I agree - similar experiences with GMC.

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ssilover1 2 years, 8 months ago

Your comment has nothing at all to do with cardiology. And your experience is not in a subpar community. You should be ashamed of writing that. There are many, many outstanding people here who deserve the best of the best.

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news2me 2 years, 8 months ago

Guess donnaj drove to Eastside blindfolded with her sub-par community comment.

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news2me 2 years, 8 months ago

Have you seen the homes that immediately surround Eastside? I am sure that these Brookwood upper middle class residents will be delighted with your sub-par community comments. So what high class community do you live in?

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lhellermd 2 years, 8 months ago

Performing coronary angioplasty and stenting at hospitals without on site open heart surgery makes sense in rural settings where patients do not have easy access to a cardiac center. Gwinnett Medical Center is 8 miles from Eastside Medical Center (ESMC) and has has recruited 2 superb cardiac surgeons who have been practicing in Atlanta for years. Why would anyone choose to have a cardiac procedure at a new low volume community hospital (ESMC) when there is a full service cardiac center down the road?

NONE of the cardiologists in Gwinnett County supported Eastside's application for an angioplasty program. There is no benefit to the community. Starting in May, patients who find themselves at Eastside's emergency room will no longer be able to see ANY of the cardiologists who have serviced Gwinnett County for decades. And if they need emergency heart surgery, they will be shipped to Piedmont Hospital in Atlanta.

So how did this come to pass? Well, when folks say "its not about the money"......

Louis I. Heller, MD, FACC Director, Cardiac Catheterization Lab Gwinnett Medical Center

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kevin 2 years, 8 months ago

There is nothing wrong with Piedmont doctors. The biggest difference between GMC and other hosptials is that at GMC you will get charged 100% more often for your health care because they sub-contract more employees/doctors,etc than any other hosipital I have been to. At least at Piedmont, they send one bill for all your services to your insurance company. Blue Cross/Blue Shield is the worse of them all. Their policies nover contain a cluase that protects you from sub-contracted staff medical bills. You get stuck with the whole thing because most sub-contractors are not in theri network. If you don't check this out before going to GMC, you are the sucker/loser.

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michelleb 2 years, 8 months ago

Don't have to worry about how bad Blue Cross and Blue Sheild is because Eastside no longer accepts them. Just got my notice from them last week tellling me to go to GMC

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kevin 2 years, 8 months ago

This exact same issue came up from Emory when GMC wanted to do heart surgery. GMC needed approval and permission to get it done there. Why not Eastside?Like I said before, if the partnership benefits the insurance holders, go to Piedmont/Eastside. If it benefits Blue Cross, Blue SHield, go to GMC. A least now Gwinnett residents have morechoices to decide where to go and to get their insurance companies to pay 100% of the bill, or you can accept paying a big chuck yourself.

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Say_that_again 2 years, 8 months ago

Why go to Eastside? GMC accepts more insurance plans than Eastside and has better ratings from former patients.

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LEX2091 2 years, 8 months ago

I HAVE BEEN TO GMC FOR PROCEDURES AND I WAS VERY IRRITATED THE WAS I WAS TREATED. I WOULD LIKE TO CHOOSE MY HOSPITAL, INSTEAD OF HAVING ONE CHOICE. ESPECIALLY WHEN IT COMES TO HEART PROCEDURES. IT SOUNDS TO ME, THESE CARDIOLOGISTS ARE MAD BECAUSE MONEY IS NOT GOING IN THERE POCKETS. I WENT TO EASTSIDE FOR MY LAST SURGERY AND I WAS VERY IMPRESSED WITH THE DOCTORS AND NURSES THERE. THEY WERE VERY PROFESSIONAL AND KNOWLEGABLE. GO EASTSIDE!!!!!!!

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Say_that_again 2 years, 8 months ago

Glad to see that you are on board for a single payer insurance system. The only way we are going to get to choose any place and any doctor we want. Medicare does a great job of allowing choices! Why can't we all have it?

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lmlesser 2 years, 8 months ago

Some of the cardiologists who are no longer on the staff at Eastside as of May 1 were offered positions by Piedmont and turned it down because the partnership is bad for Gwinnett county residents. Many in the community have fought hard to have open heart surgery in Gwinnett which enhances all aspects of a hospital. Siphoning off patients to Piedmont is just bad for our citizens. Believe me, its not about the cardiologists' loss of money! Lanny Lesser

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Realist3 2 years, 8 months ago

As is always the case, there are likely several sides to this story, many I have to assume aren't being told or publicized. Bottom line, this means more services, more highly skilled physicians, and continued advancing services and availability in our county. Patients should have a choice and they will.

One reality that no one wants to acknowledge is that every healthcare organization is also a business Not just hospitals but physician practices, imaging centers, the list goes on.

Also, it seems that an intelligent blogger above gets it. Non profit hospitals are focused on the bottom line, making business decisions, just like everyone else......they just aren't paying taxes. It may be more accurate to refer to hospitals as "tax paying" or "tax exempt".

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news2me 2 years, 8 months ago

Seems we have two new posters that will be sure to sign on regularly and contribute often to various subjects besides this one. Or maybe not?

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pfnurse 2 years, 8 months ago

Let’s look at who is benefiting from the firing of all heart doctors at Eastside Medical Center – not the citizens of Gwinnett County who will ultimately be transported out of the County for heart surgery and not the patients who will lose having their regular cardiologists look after them at Eastside. This move creates an EXCLUSIVE partnership with Piedmont Hospital and their own heart doctors. The public really needs to know the reason for this. It is because the hospital wants to bring to the Snellville community something that Lawrenceville has. –The answer is GREED and PRESTIGE. Why not - this has to do with more money for the hospital and money for the Piedmont group. This is the trend of hospitals lately – screw the dedicated, hard working doctors and bring in a new group for a PRICE– this is the current American way that has caused our nation to decline so rapidly lately. It is like building a million dollar factory within a few miles of the same factory.
This Eastside Medical decision is from a dictatorship and will create anarchy. They may rise briefly but, wait, they will definitely fall. The existing cardiology groups that have been at Eastside for decades will survive this dictatorship. The patients that trust and have ongoing commitment to their doctors will follow them.
Remember dear public – there is good medical care and there is definitely bad. Most of the doctors that are being terminated can treat patients at Gwinnett Medical Center. They are just committed to quality care. These mergers for exclusive care have kicked many hospitals in their backsides. I cannot wait to see this hospital fail. Pray they will not be risking lives for their own financial gain.

A Nurse that has only cares about safe and quality patient care.

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ssilover1 2 years, 8 months ago

Our family feels totally betrayed by Eastside's management. We will stick to our cardiologist and go to GMC, BUT if there is a negative outcome because we have to travel farther, then you can imagine the next call we will make.

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ssilover1 2 years, 8 months ago

Well, today the second cardiiologist that I use has sent me a letter that her group will not be using Eastside for services...the other one was for my husband and now mine. I am beyond angry. What can be done about this?

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davbet 2 years, 8 months ago

I went to Eastside with chest pains and nausea and was told in ER by a staff doctor that I was having a heart attack. They sent me via ambulance to Piedmont (sirens, lights, the whole drama) for a heart cath. NOTHING was wrong. However, I developed a pseudo-aneurism from the cath and had to have emergency surgery. A cause was never established and it cost me a lot of pain (I'm allergic to narcotics), a week's hospital stay and time off work. Since then I have been seeing a Gwinnett Consultants in Cardiology doc who consults with my other doctors when needed. I can no longer use him at Eastside even though his office is attached to the hospital. All I can say is that Eastside is going to lose a lot more money over this move from the exodus of patients to Gwinnett Medical Center.

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