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Physician flight concerns health officials

November 26, 2003|by DON AINES

chambersburg@herald-mail.com

CHAMBERSBURG, Pa. - Physician flight from Pennsylvania is posing a challenge to health care at Chambersburg and Waynesboro hospitals, which are now looking to Norway to help fill gaps in some specialties, according to Summit Health President Norman B. Epstein.

"This past year, all of the GI (gastroenterology) specialists and most of the orthopedic physicians who serve Waynesboro Hospital were forced to leave the state and are now working in Maryland," Epstein said during the annual meeting Tuesday of the Chambersburg Hospital Board of Directors. "Only four of six orthopedic specialists remain to practice in Chambersburg," he said.

"Inadequate reimbursement and confusing regulatory and billing issues" are among the reasons doctors leave the state, Epstein told the board. "These issues, in addition to the liability insurance crisis, are forcing more and more physicians to give up the practice of clinical medicine," according to Epstein.

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The problem is particularly acute in Waynesboro "because they're right near the Maryland border," Epstein said. Some doctors have left because of liability issues and having to pay additional insurance to practice in the state.

That is one reason Summit Health, the owner of both hospitals, has been recruiting specialists from Norway, he said. Two gastroenterologists from that country are working in Waynesboro and Epstein said a cardiologist will begin work in Chambersburg within two months.

Cumberland Valley Medical Services, an affiliate of Summit Health that employs physicians to work at the two hospitals, once only recruited family practitioners, but now hires specialists out of necessity, he said.

Summit Health has used other methods to attract physicians and recruited 33 to the region last year, according to Epstein.

Nonprofit organizations, such as Summit Health, normally cannot give money to for-profit entities, such as private practices, he said. There are exceptions, however, such as providing start-up assistance for specialties deemed critical in rural areas, provided the practitioner agrees to stay in the area for a specified amount of time.

The scarcity of some specialists has resulted in patients waiting weeks for appointments, according to Epstein. Until Summit Health formed a partnership with Keystone Health Center to bring in an ear, nose and throat specialist part of the week, he said area Medicaid patients waited up to seven months to meet with one in Hershey, Pa.

Despite such obstacles, Summit Health performed well financially in the year that ended June 30, according to Patrick O'Donnell, the vice president for finances.

Revenues were $199.1 million, up 12.6 percent, primarily due to higher patient volumes and Medicare reimbursements. Total expenses were up 9.1 percent to $189.1 million, according to O'Donnell.

Chambersburg Hospital had revenues of $147 million, up 13.6 percent, while Waynesboro revenues increase 7.7 percent to $39 million.

Not included in the hospital figures are revenues and expenses for other Summit Health affiliates. The net surplus for Summit Health increased $2.6 million to $8.7 million last year, which will be used for building projects, physician recruitment and the Summit Endowment, according to O'Donnell.

Epstein said Chambersburg Hospital is going forward with an $11 million emergency room expansion. Hospital officials also have outlined plans to expand its oncology center and build a new patient care building on the campus at some point in the future. Waynesboro Hospital has been acquiring adjacent properties for possible expansion in the future.

Chambersburg Hospital has been approved by the Pennsylvania Department of Health to add interventional cardiology services, allowing stent implants there, Epstein said.

Expanding services, however, depends on the number of doctors who can perform them, according to Epstein.

"Without the physician specialists, it doesn't matter how many buildings you have," he said.

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