Liz Freeman|Naples
Yard signs are cropping up like it’s political season against the NCH Healthcare System and its plan to limit which doctors can admit patients to its hospitals.
The 400 yard signs are part of a campaign by people who are angry that NCH intends to take away their independent primary-care physicians' option to admit patients and direct their care while hospitalized.
The Collier County Medical Society has retained a public relations group, and newspaper ads and TV commercials will be running to help educate the community about the policy, said April Donahue, executive director of the medical society. A petition started by the medical society has 2,000 signatures so far against the admissions change, she said.
At issue is NCH’s plan to expand a pilot study conducted over the summer on two hospital floors where only NCH-employed hospitalists admitted patients and were in charge of their care. NCH plans to roll out the policy to other floors. Hospitalists are based in hospitals and can be part of a physician group, employed by a hospital or contracted by a hospital.
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The policy change means independent primary-care physicians, including independent concierge physicians, will no longer be able to admit and won't bein charge of their patients while they are hospitalized. That includes not being able to order tests, make entries in medical records or determine discharge, according to the medical society.
In essence, an NCH-employed hospitalist would be put in charge even if the hospitalist does not know a patient’s medical history or have access to the patient's outpatient medical records.
NCH officials say the pilot resulted in reduced lengths of stay andfewer readmissions,and that patients liked it. The hospitalist would makerounds twice a day on the floor with a support team that included pharmacy, rehabilitation and other services to be more efficient.
“I have not had one single patient tell me they think this is a good idea,” said Dr. Cesar De Leon, president of the medical society. “We have the support of the entire medical staff.”
At the Oct. 23 meeting of the NCH medical staff, physicians voted unanimously against the planned admissions change, Dr. Paul Jones, the president of the NCH medical staff, said in a guest column in the Naples Daily News that ledto his forced resignation, according to De Leon.
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The medical staff vote and requests from the public to reconsider the policy have been made to Dr. Allen Weiss, president and chief executive officer of NCH.
“It doesn’t make sense for a leader to not seek the support of the entire medical staff,” De Leon said. “A lot of donors (to NCH) are on our side and have been sending money to the medical society. Any leader would seek to have the engagement of the medical staff for patient care.”
The medical society has received more than $75,000 in donations to help boost awareness of the policy change, Donahue said. The money has been used to makea video for physician members to inform patients of what’s going on, and some of the money will be used for the print and TV messages.
Millennium Physician Group is providing patients with laminated cards that say the person is patient of a Millennium doctor and wishes to be seen by a Millennium physician while in the hospital. Millennium primary-care physicians and its hospitalists would be subject to the NCH policy and unable to admit patients and direct their care.
Officials at Millennium declined to comment on when the card distribution began.
The executive committee of the NCH board of trustees will havea regularly scheduled meetingDec. 11, and the rest of the NCH board hasbeen invited to attend, according to the medical society.
“Yes, we have invited any board members who would like to attend,” NCH spokeswoman Debbie Currysaid in an email.
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One of the topics will be thepatient-centered care pilot program that involves the hospitalists, Curry said.
The yard signs that are popping up in neighborhoods say “NCH Denying Patient/Physician Choice.” The signs were made by someone who wants to remain anonymous, and the signsare available at the medical society, Donahue said.
“Each day I see more and more,” said Joe Trachtenberg, a member of the Aqualane Shores Homeowners Association board.“Even at business establishments.”
There is huge interest in the NCH policy amongPort Royal, Aqualane Shores, Royal Harbor and other residents who have retained independent concierge physicians for the purpose of a more dedicated and hands-on relationship, he said. That relationship would be disruptedwhen the residents are hospitalized.
“I would say up in arms is correct,” he said, about how people are reacting.
Trachtenberg requested a meeting with Weiss on behalf of the Aqualane Shores association several weeks ago and it has not been forthcoming.
The community is hearing two different things and it needs to be addressed, he said. NCH is saying the policy move is good for patients yet residents are upset about their independent physician not being in charge when they need it most: at the time of a hospital stay, he said.
Primary care physicians recognize the role of hospitalists and don’t object to their presence, he said. The question is the necessity for changing the admitting status of independent primary care physicians.
Another issue is how many patients would be affected and a wide difference between NCH’s projection that 3 percent of patients are admitted by independent primary care doctors and a projection of 50 percent that Jones used in his guest column.
“We are speculating that the 50 percent number used by Dr. Jones included physician specialists such as obstetricians, pediatricians, and surgeons, who are not affected by the patient centered care model,” Curry said.
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Jean Humphries, a decades-long resident, said NCH is a community hospital for the entire community and has historically received donations from the community. The admissions policy is wrong based on NCH’s history, she said.
Her elderly mother lives near NCH Downtown Baker Hospital and has a concierge physician who would not being able to admit her at NCHbecause of the policy. That creates a burden to travelacross the county to another hospital.
“It’s just not right,” Humphries said, adding that everywhere she goes people are angry about the admissions policy. “It’s all we talk about. We’ve got to stop it.”
