Heart attack: Competitors threaten core franchise of St. Thomas

UPDATED 3:29 p.m. Friday with confirmation from VUMC... Of three cardio doc groups, one is gone as of Monday and two others are negotiating for possible move to VUMC or Centennial; high-level exec departures at Baptist and benefit cutbacks add to sense of crisis

Email | Print By E. Thomas Wood

UPDATED 3:29 p.m. Friday:

Vanderbilt University Medical Center spokesperson John Howser this afternoon confirmed that talks are underway with one of the two heart groups left at St. Thomas.

"We are in the process of growing our clinical cardiology and cardiac surgery programs to match the size of of our cardiology research program," Howser said. "We are in discussions with one of the remaining cardiology practices at St. Thomas and are very interested to work something out to bring them to Vanderbilt."

AS ORIGINALLY FILED:

The financial and operational turmoil that has afflicted Nashville's St. Thomas Health Systems for years has reached a new level, as cardiologists at STHS flagship St. Thomas Hospital -- which has built its reputation on heart care -- may be moving to competing hospitals.

NashvillePost.com has learned that Vanderbilt University Medical Center and HCA-owned Centennial Medical Center are locked in a bidding war with St. Thomas Hospital over The Heart Group PLLC and St. Thomas Cardiology Consultants LP, the two main independent cardiology practices currently based at St. Thomas.

A third group of heart physicians, Page-Campbell Cardiology Group PC, will complete its departure from St. Thomas for Vanderbilt on Monday, ending a transition that began with the establishment of a Page-Campbell outpost at Vanderbilt in 1999.

For St. Thomas Hospital, a pioneer in open-heart surgery locally whose internet homepage highlights its status as "#1 in Tennessee, top 5 percent in the nation for heart surgery and overall cardiac services" and makes several other references to its cardiology capabilities, the implications of losing either of the two remaining groups of heart docs are far-reaching.

For parent organization St. Thomas Health Services, owned by St. Louis-based non-profit healthcare system Ascension Health Inc., the potentially devastating loss of cardiology business would only compound difficulties as operational problems continue at Baptist Hospital, acquired by STHS in 2001.

Within the past ten days, NashvillePost.com has learned, Baptist chief financial officer Mike Johns and chief nursing officer Liz Johnson have both left their jobs.

"We've made some changes, and we are going to continue to make the tough decisions that are necessary to remain a strong and vibrant organization," said St. Thomas Health Services spokesperson Rebecca Climer. She denied rumors that Ascension had engineered or dictated the recent moves, saying: "We are a strong leadership team, and we hold ourselves accountable."

There are other signs of organizational distress at St. Thomas Hospital. At a recent meeting of staff nurses, administrators announced they would lop eight hours of paid time off from each nurse's accrual balance. When asked why, by the non-unionized nurses, they were told: "So we won't have to fire you."

The rollback of paid time off, Climer explained, applied to all employees, not just nurses. She said it amounts to a reduction of 0.3 hours per pay period in accrual.

As to any possible departure of cardiologists from St. Thomas, Climer stated: "Our cardiac capabilities are not limited to any small group of physicians."

St. Thomas Hospital spokesperson Paul Lindsley said the facility has been "the cardiac leader in this market" since 1967, and that its reputation and patient volumes confirm that it remains the market leader. He noted that St. Thomas is just today announcing its participation in a clinical trial of a new type of implantable cardioverter defibrillator.

"It's a competitive market." Lindsley said. "It's business-driven. Doctors come and go. But if some doctors do leave us, that's not the destruction of a program."

But the loss of Page-Campbell alone seems certain to affect patient volume at St. Thomas. An article in Vanderbilt's in-house VUMC Reporter recently predicted that "Page-Campbell's move could bring up to 20,000 new patients to Vanderbilt's existing roster of about 28,000." Those patients would have to come from somewhere.

A physician at one of the cardiology groups on the block told confidantes recently that any buyer "would have to make an unbelievable offer" to lure it away from its current position as an independent ally of St. Thomas. This senior cardiologist said the ongoing discussions were just meant "to keep 'em honest" at St. Thomas.

Another doc, however, noted that his group's practice would never be worth more than it is today, with multiple suitors courting it.

NashvillePost.com has learned that Vanderbilt has made individual offers to some physicians from the groups now being courted. Even those who would prefer to remain at St. Thomas are in a bargaining mood: "We're the last man standing," said someone from one of the cardio practices in play. "What are you going to do for us?"

Previous NashvillePost.com coverage of issues at St. Thomas and Baptist:

German steps down at Saint Thomas, Beeman fills in (November 16, 2004)

Financial losses at Baptist, executives initiate review (November 22, 2004)

Beeman on his way out at Saint Thomas Health Services (January 17, 2005)

Saint Thomas system names interim CEO (March 30, 2005)

St. Thomas names new president/CEO (March 14, 2006)