By Meredyth Albright - Editor - malbright@rhinelanderdailynews.com

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Ministry Health Care has directed its physicians to refer patients with cardiac issues to St. Clare's Hospital and Marshfield clinic cardiologists, a directive that has a competing cardiac care provider feeling cut out of the loop.

An e-mail sent six weeks ago to Ministry Medical Group providers and managers outlines the services provided at St. Clare's Hospital, Ministry's new hospital in Weston by interventional cardiologists and cardiac surgeons at Marshfield Clinic.

The memo, from Dr. Robert Sookochoff reads “the expectation is that all transfers of acute patients from our emergency rooms or inpatient setting in any of our regional hospitals should be either to St. Clare's or St. Joseph's hospital (a ministry hospital in Marshfield.”

Tim Loggeman M.D., president of Cardio Vascular Associates of Wausau, which has provided cardiac services in Rhinelander for the past 13 years and in Eagle River for 17 years said their concern is about their patients.

His concern is that the choice of patients is being eliminated and that Ministry Health Care physicians will refer to St. Clare's when a patient has previously seen a physician from Cardio Vascular Associates or would like to be treated by cardiologists from their group.

“If I have a patient that calls with a concern and I tell them to go to the emergency room they could be sent to another cardiologist at another hospital,” said Loggeman. “That's a concern to me, it could be a long standing patient who's been seeing one of our physicians for four or five years and I'd like to have their wishes respected.”

The ministry memo goes on to say that “each MHC/MMG site and clinician will be monitored with respect to referral performance - 90 percent compliance is expected.”

Monica Hilt, president Saint Mary's Hospital said “when a patient requests a referral to another health care provider that gives us an opportunity to learn more about what we can do to enhance our services and provide more thoroughly for the needs of our community.

“As employees of Ministry, the physicians can tell us why those referrals moved outside of the system so that we can address any patient concerns,” Hilt said.

Loggeman said the memo didn't surprise him or his partners at CVA.

“Businesses are moving to keep patients in their system,” he said. “As an independent I find it disheartening that a group outweighs an independent.”

Loggeman said “it's hard to know if any lines have been crossed” in the memo sent to Ministry providers, but that CVA is asking the Wisconsin Medical Society if the memo was appropriate behavior.

A spokesperson for the Wisconsin Medical Society said that organization doesn't have a process for addressing concerns of this type. She said if the issue were related to quality of care there are oversight organizations that would address it. The society represents individual physicians.

In regard to the statement in the memo that each site will be monitored, Hilt said the organization has never effectively measured referrals in he past, but we are trying to so now. We are looking to develop a process to track those referrals effectively.”

She said that patient choice will always be determinative and that the decision as to where to go for further care should be the result of an extensive conversation between a patient and the physician.

Loggeman however, has concerns about what that means to patients who are in vulnerable health care situations.

“Our first concern is providing the best patient care and responding to their wishes,” he said.

Hilt said that Ministry Health Care believes that the quality of its program is unmatched in the region and that most patients will choose to receive care in it.

She said if a patient chooses to be treated at another facility “we will honor that choice and facilitate e the transfer of the necessary information immediately.

Loggeman said this is the first time an issue of this nature has been raised. He said the communities in which they have offices either have independent hospitals or hospitals affiliated with Aspirus. CVA is an independent medical group that admits patients to hospitals in all of the communities it serves, but performs procedures, if required, at Aspirus Wausau Hospital.

In addition to Saint Mary's in Rhinelander and St. Clare's in Weston, Ministry has hospitals in Sturgeon Bay, Eagle River, Park Falls, Merrill, Woodruff, Oshkosh, Stanley. Tomahawk, Weston, Wabasha, Minn., Steven's Point, Appleton and Chilton.

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Gerald Dall wrote on Apr 9, 2007 9:38 AM: " It appears to me this is nothing but greed by Minestry Health Care and the concern is money not the patients welfare. It might be time for someone to question the way the administrator is functioning. Seems like there has been a lot of negativity that wasn't there before the previous administrator retired. " The comments above are from readers. In no way do they represent the views of the Rhinelander Daily News.

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