Today’s edition of INSIDE ENH will be a fact checking of the recent “Guest View” from the ENH Board Chairman. It appears to have been inspired by a letter I placed in our local paper last week. My claims were stated to be “not true, exaggerated and unfair to the community”. I therefore re-read my letter to match Mr. Muscato’s accused inaccuracies with my previously published insights. The problem was that he didn’t really address or refute my assertions. He did make several points, some valid, some not. But he never addressed any specific untruths, exaggerations, or inaccuracies that I had claimed in my letter. So while I had asked for a dialogue, what he offered were essentially a reiteration of the ENH talking points. For those who have been engaged in the conversation over the past several months, this may be a bit of a rehash, but I would like to address several issues that the Board Chairman addressed: 1) There has been a significant downtrend of inpatient care at ENH. I don’t disagree with that statement in general. But, the surgical inpatient population decline at ENH is significantly higher than in other geographic areas. Consider; roughly 90% of orthopedic care, 80% of urologic care, 90% of ENT care, 100% of Plastics and Hand Specialty care, and 65% of ALL Ambulatory Surgical care, leaves this community. To quote trends is one thing; to use them to hide the mass exodus of patients is, in my opinion, disingenuous. 2) “Dr Schratz claims that Newfane Hospital is closed. As a physician, he knows that is not true and his statement is highly irresponsible.” Well, Mr. Muscato may be a trial lawyer, but I have never been made aware of his credentials as a mind reader. For him to know what I think, while arrogant, is inaccurate. You see, I am a simple surgeon. Mine is a relatively black and white world. A hospital is a building where I can take out gallbladders, appendixes, and colon cancers. An Urgent Care Center is a building that a patient goes to be told that they need to go to a different building, ( a hospital), to have said organs removed. (I will speak more to the irresponsible claim in a moment). 3) “The doctor chooses to ignore trends”. On the contrary, we revel in trends. That is where our next patient might come from. We constantly ask our referring physicians, poll our patients, and ask our neighbors, how we can change, expand, and morph, so as to meet their needs. That is why we opened our Surgical Center. People asked for it. And it precisely that openness, transparency, and dialogue that we have been asking of the ENH Board and Administration. 4) “I believe the doctor claims 35% of surgery patients are going to Buffalo”. Well first of all, it is probably well north of 70%, but forget that. He is the Chairman of the board, why doesn’t he know the exact number!!! 5) “After the doctors’ opening of their office surgery program, the hospital lost $750,000 in annual revenue”. Given all of the “trends” out there, I am not quite sure how they can pinpoint that revenue loss to us. But in a ystem where recent ENH 990’s tell us that the annual revenue to ENH is $70,000,000, I worry when 1% revenue loss can be so devastating. 6) The idea that Dr. Hodge being on the Board of ENH made confidential info available about the outmigration of ambulatory surgical patients is nothing short of laughable. Everyone knew of the stream of patients leaving our service area. As is Mr. Muscato’s statement, “We learned of it, like most, through the media”. A lecture from this board and administration about transparency and open communication? Simply stunning! 7) It is true that Dr. Hodge and I received compensation for all of our efforts at both Newfane and Lockport Hospitals. Mr. Muscato, however, is either unaware of, or unwilling to offer proper perspective. Bob and I took 26 days of call/ month for free, for years. When we became the only two surgeons on staff, we were not required to take any call, but continued to take call. The hospital began paying other surgeons who took the 4-5 days/month we could not cover, a reported $750/day. Most surgeons in WNY were being paid $750/ day or more for call. We continued to provide surgical coverage for both hospitals for approximately $125/ day. And at the time we were generating roughly $4,000,000/ year in revenue. To pay $80,000/year for a $4,000,000 return on investment sounds like a pretty good deal. Particularly in light of the fact that over the past 4 years, the hospital is reportedly paying general surgeons $350,000 -$400,000 and seeing pennies on the dollar in return. 8) “Apparently, Newfane was inconvenient for the doctors”. Driving up to that facility in the middle of the night was inconvenient. But we did it because we care about the people of that community. And I resent Mr. Muscato’s mind reading as to our intentions. 9) It is true that I had a pleasant breakfast with Jack McHugh, and a meeting with Mr. Muscato. We also met once with the executive committee of the board regarding working together on an Ambulatory Surgical Center. And it is accurate to say that there was no resolution. The question is why? We expressed an interest in working together with one stipulation. We could not and would not go into a business with the current CEO. Why? Two major, show stopping reasons; no surgeons would come if she was involved, and the way she treated employees. Sound familiar? As there was no interest in changing CEO at that point, there was no need for further discussion. 10) “The doctors profess to want a dialogue,……” I would disagree with the Chairman’s recollection of events. I at no time encouraged the group to leave. I did stand up and ask if the group wanted to hear what Mr. Muscato had to say after several months of silence. The majority said no and left. Those that cared about what he had to say stayed and may well have enjoyed the experience. 11) “It certainly makes me believe the doctor’s aspiration of openness and discussion is insincere and hollow”. Another psychoanalysis of me when the focus should be ENH and its spiral into irrelevance and economic ruin. I value a dialogue, now more than ever. But none of us need the type of lecturing, reiteration of talking points, and finger wagging that Mr. Muscato and the ENH board offer while the patient exodus for healthcare outside Eastern Niagara County continues to accelerate. 12) “The Board’s stake in this decision is a desire that our hospital adjust to available resources. On the other hand, the doctor is angry over ENH’s objection to his proposed ambulatory center and now, unfortunately, is in competition with the hospital.” But the hospital’s biggest problem is not the changes in available resources from payors. The real challenge is reclaiming the thousands of patients that stream down Transit Road for care that could and should be delivered locally. (Have you noticed all the Billboards on Transit, there is blood in the water and other healthcare systems are taking advantage of ENH’s weakness.) And I am not angry over the hospital’s objection to our ASU. That was to be expected. What I am angry about is the deceit they used in the process, and how it has distracted the ENH Administration and Board from their real purpose, which is the stewardship of our healthcare system. I have been accused of being irresponsible. I would disagree with that moniker, but will let my actions and words over the past 23 years speak for themselves. I believe the irresponsibility lies with those currently in control, or purportedly in control of ENH: namely the Board of Directors and Administration. They can deny, defend, deflect, and stonewall, but they ultimately are responsible for the future of ENH. It is their responsibility, as scary as that might sound.
Posted on: Fri, 12 Sep 2014 00:18:25 +0000
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