Waukesha County doesn’t need another hospital

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I am an independent physician employed by neither Aurora Health Care nor ProHealth Care. I am also a resident of the Lake Country area. Having trained at Harvard and the Mayo Clinic, I have an understanding of quality health care.
Community hospitals serve the community where they are located and grow with that community as their needs change. ProHealth has added facilities and programs as our community grows. Aurora has attempted to spread out to the whole eastern part of the state.
If Aurora builds a Town of Summit hospital and later feels it needs more resources elsewhere, will their "western" facility suffer the same fate as Sinai in downtown Milwaukee, where resources are being pulled back?
Aurora is misleading the public about the need for this facility. It is unfair, and I personally feel, unethical, for Aurora to imply that the current health care is somehow inadequate.
Aurora states that another 24-hour emergency department is needed. The Oconomowoc Memorial Hospital emergency department has received a 99 percent approval rating in an independent survey. All of the physicians are board certified. Waits are short, and the care is excellent.
Aurora also states it will provide care in a "new" way with integration and a patient-centered model. Any physician who puts the patient first
is using a patient-centered model.
The current facilities are truly integrated. All physicians on staff at Oconomowoc and Waukesha Memorial Hospitals can look at X-rays, CT scans and MRIs from their offices or homes. Our office will soon be integrated with the hospital with a fully electronic medical record, synchronized with the hospitals’ computerized record system.
Implied in this propaganda is some inadequacy of the
current health care delivery system in western Waukesha County. What deficiencies exist at Oconomowoc Hospital? The facts support that there are none. If Aurora or the Wilkinson clinical practitioners believe there is, they should let it be known.
What about the 400 new jobs Aurora has promised? Where will these employees come from? There already is a nursing shortage. Signing bonuses will be offered to entice employees; corresponding retaining bonuses will be countered from the current employers. This will cost money. Where will this money come from?
Aurora claims the residents of Waukesha County need a choice in health care. It is true that some of the county’s residents leave the area for care. There are several reasons for this. One of those is that Aurora-employed physicians are given financial incentives to refer patients to Aurora facilities. These patients could be treated locally, but because the specialist in our community is not employed by Aurora, their system loses money if other non-Aurora physicians treat the patients. This is really what this is all about, isn’t it? Aurora wants to capture this revenue it is now losing.
The residents of Waukesha County are fortunate to have excellent, well-trained doctors to provide care. Wilkinson Clinic has many excellent physicians. Unfortunately, the doctors of Wilkinson decided several years ago to sell their practice to Aurora. The Wilkinson doctors are now employed by Aurora and have a non-compete covenant, which prevents them from practicing medicine locally if they leave Aurora.
I feel badly for my cohorts, excellent physicians, who are disgusted by their employer, and yet are powerless to do anything if they want to continue to practice in their community.
The major focal point of the debate has centered on the benefit of "competition" that a new hospital would provide. Many use the analogy of stores lowering prices as they respond to local competitors. How could this not translate to a hospital?
In health care, the majority of payment is made by a third party, the insurance provider. The consumer (patient) does not know the price of anything before they "purchase" it. Additionally, the "choice" the consumer makes is actually made by another party, the doctor.
It is no wonder that the consumer has so little control in pricing. To make matters worse, most doctors refer to facilities they are connected to, so again the consumer has little choice. I wonder, if a new facility was built by Aurora, how many of their physicians would refer outside of the new hospital?
This is obviously a complex issue with a heavy emotional burden. I urge all residents to get the facts, and decide what they want. If a new hospital is desired, so be it. But be ready to pay for it.
Rick F. Papandrea, M.D., is an orthopedic surgeon with
Waukesha-based Orthopaedic Associates of Wisconsin S.C.
August 20, 2004, Small Business Times, Milwaukee, WI

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