OHSU ending Cardiology at MCMC but why?
By Tom Peterson
Jack LaFond at his fishing camp on the Deschutes River when he was operating Youngs Fishing Service. LaFond who has had heart trouble is now finding out his cardiologist is leaving as OHSU is terminating an agreement to provide cardiology at Mid-Columbia Medical Center.
Former fishing guide Jack LaFond used to run a fine line between the rocks with a jet boat on the Deschutes River.
He’s seen some rough water.
And his retirement has had a few tight spots as well. He’s had a stent put in his heart and then he underwent double bypass surgery.
So, the news that OHSU will be eliminating its cardiology group on Aug. 31 in The Dalles is “concerning,” he said.
He really likes his OHSU Dr. Kevin Wei who works at Water’s Edge next to The Dalles Bridge.
“I’ve been very very happy with how OHSU has been involved for the past few years. My care in the past has been terrific not only with cardiology but with MCMC (Mid-Columbia Medical Center) itself. I hate to see that shaken up,” he said.
For him, OHSU Cardiologist Dr. Wei provides him the care he needs.
But that will change soon as Wei and three other OHSU cardiologists are set to discontinue the practice in The Dalles after an agreement between MCMC and OHSU was abruptly ended earlier this month.
CCCNews reached out to an OHSU cardiologist and his wife (who is also a doctor) to better understand why the breakup is occurring. Within minutes, MCMC’s Travis Dray called. He said CEO Dennis Knox would be answering questions.
We also posed the question to OHSU and received the following email after a request for a phone interview.
Tamara Hargens-Bradley Senior Director with OHSU Strategic Communications.
“In recent weeks, MCMC publicly expressed its intentions to end its existing contractual relationship with OHSU and establish new contractual relationships with other health systems and cardiology providers,” said Tamara Hargens-Bradley Senior Director with OHSU Strategic Communications.
“OHSU understands that this announcement caused OHSU’s cardiologists to identify and pursue their options to practice cardiology elsewhere. OHSU is not renewing its cardiology services agreement with MCMC because it is likely losing the professional resources necessary to perform the agreement,” she said.
MCMC CEO Dennis Knox disagreed with that statement vehemently.
“We did not terminate it. It was OHSU,” said Knox on Friday, May 21. “That is not true - absolutely not true… That is the first time I am hearing this. It is simply not true. I refute that.”
Neither Knox nor OHSU gave a definitive reason for the discontinuation of service.
But the results of the decision are clear.
Cardiologists are leaving.
The OHSU Cardiology group operating at Waters Edge consists of Bassel Beitinjaneh, MD; Matthew LaBarbera, MD; Kevin Wei, MD; and Mrinal Yadava, MD.
Knox said he was hopeful that Yadava would continue to provide care for MCMC.
Dr. Betinjaneh has already reduced his schedule to two days a week at MCMC and will be spending more time at OHSU, said Knox in a letter to patients.
LaBarbera has sought another opportunity out of state and will be leaving MCMC on July 1. He will be available by phone for questions until July 31, the same letter states.
That also has the effect of causing Pediatrician Jacklin LaBarbera of MCMC to leave as well.
The couple is moving to New York, Knox said.
Relationships Between Patients and Doctors
Meanwhile, LaFond said Wei was easy to get along with and talk to.
“He commutes every day to The Dalles, even in the wintertime - Oh my God. He’s dedicated.”
LaFond also said he received excellent care at OHSU in Portland when he had double bypass surgery. “Everybody was wonderful. I was extremely happy with their partnership with MCMC here,” he said.
Steve Pribyl of the Dalles has had two trips via LifeFlight for heart attacks - one in 2012 and one in 2018. Both happened after a fishing trip.
“I had nothing but quality top-notch experiences with MCMC and OHSU,” he said. Pribyl, a retired fish biologist with ODFW, is a patient of Dr. David Guarraia, a cardiologist who was with OHSU and working at MCMC. But Guarraia moved to St. Charles Medical Center in Bend in 2018.
Pribyl still sees him, willing to drive 130 miles to do so. The relationship is that important, he said.
Steve Pribyl with a bass on the Deschutes River. The avid angler and fish biologist has had two heart attacks and received ‘top-notch care’ from the collaborative efforts of OHSU and MId-Columbia Medical Center. So why the change?
In his second heart attack, Pribyl said he was fishing for Spring Chinook on the Hood River and then hiked up a steep incline with 20 pounds of gear on his back.
He did not feel well. He drank some coffee and on the ride home had to pull over to vomit near the Discovery Center. He said he laid down in his pickup and was nearly unconscious. A friend of his happened to pass by and saw his truck on the side of the road. He tried to call Pribyl, but he didn’t answer. So the friend called Pribyl’s wife and she called him. Pribyl answered and soon an ambulance was on the way.
Pribyl got a second ride via helicopter to OHSU for treatment.
Pribyl said on both instances, he was to OHSU within 30 minutes of being loaded on the aircraft.
“You would not get this level of care without these relationships,” he said of his caregivers. “At the end of the day, what’s it worth to open your peepers the next day?”
So Why Is OHSU Cardiology Leaving?
On May 3, OHSU gave MCMC notice of nonrenewal of the Cardiology Services, said Hargens-Bradley with OHSU.
“OHSU deeply regrets that this collaboration could not continue. OHSU is committed to maintaining services until the end date and to working toward a solution that preserves access to services for patients in the community.
In 2009 OHSU and MCMC first entered into an agreement for Professional Cardiology Services with this goal to provide patients the right care at the right time while keeping them in their community whenever possible.
Since then, OHSU has made available its OHSU-employed cardiologists to provide specialized cardiology services at MCMC for the benefit of the citizens of the Mid-Columbia region.
“I think we provided great support for them,” Knox said of OHSU cardiologists. ”They have been here for years. They have been great.”
Transitioning to another group
MCMC CEO Dennis Knox
Knox said MCMC is very close to coming to an agreement to transition cardiology service to another group. “I am not at liberty to divulge that right now,” he said in regard to who the new provider would be.
“I know definitely we will have a good solid warm handoff around Aug. 31 and patients can be assured of that.”
The current relationship between OHSU and MCMC
MCMC is seven years into a 10-year affiliation agreement with OHSU. The affiliation helped MCMC onboard the OHSU paperless management system for both doctors and billing called EPIC. It serves as a hub for lab results, imaging reports, progress notes, discharges, summaries, and other medical documentation. The affiliation also created training opportunities as OHSU also operates a medical school and conducts research.
Is the affiliation with OHSU going to be renewed?
"I can’t know what tomorrow is going to bring,” Knox said. “2024 is a long way off. It’s not on my radar screen right now.”
Back in 2014, former MCMC CEO Duane Francis said the partnership was a win-win, allowing MCMC to be governed by a local board that understood the needs of Mid-Columbia while at the same time becoming a strategic partner with OHSU.
Outside of the affiliation, OHSU has also set up other care agreements similar to the cardiology group at MCMC.
OHSU provides general surgery, orthopedics, nephrology and other services, Knox said.
Will they continue?
“I have no reason to think they aren't,” he said.
MCMC Communication with OHSU
Knox said he communicates with the OHSU CEO Dr. John Hunter and Anthony Masciotra the CEO of the OHSU Practice Plan .
“We communicate very well with them, end of story,” he said. “That’s an odd question. My staff is constantly talking to them because they are supportive.”
“I am incredulous with that question,” he said. “I have answered it. You don’t need to know my schedule. I am sorry, but that is the most odd question I have had in 40 years.”
“I have 13 counterparts that speak with them all the time.”
“I have not talked with any of them today... I talked with them yesterday,” he said.
