UVa doctors lose privileges in Augusta

FISHERSVILLE — Three University of Virginia cardiologists have been told by the Augusta Health board they will lose their hospital privileges next week, impacting the 2,500 patients the doctors serve.

Augusta Health officials told the doctors in a letter that they won’t be able to treat their patients in emergencies or otherwise at the hospital in Fishersville.

The patients could either get tests and emergency treatment in Charlottesville at UVa or switch to other doctors. Elderly patients of the doctors interviewed Thursday are upset.

UVa officials said they are concerned about the patients. University cardiologists have served Valley patients since the early 1990s.

“Without their cardiologists, who know their difficult medical histories, these patients will walk into a hospital to be treated by a doctor who has never seen them before,” said Ray Costabile, senior associate dean of the UVa School of Medicine.

Costabile said the issues with heart patients are myriad, including knowing all the patient medications and health concerns.

A statement issued by Augusta Health’s board chairman, Stuart Crow of Waynesboro, did not address the three doctors. He declined to answer questions.

Crow’s statement said the board is limiting cardiology department participation to doctors “under contract to Augusta Health.”

Augusta Health has four cardiologists on staff, and will soon have a fifth, he said.

Limiting cardiology participation to the hospital’s own doctors will allow Augusta Health “to build a strong and financially viable community-based cardiology program,” Crow said.

The move will also improve department teamwork and scheduling of coronary services, he said.

The move by the Augusta Health board comes on the heels of its hiring cardiologists and announcing plans in January for a $42 million cardiac and vascular facility that would provide cardiac testing and care and a 24-bed unit. The Virginia Department of Health approved the expansion June 8.

Augusta Health raised eyebrows in Charlottesville in March 2009 by announcing the hiring of cardiologists for procedures previously handled by a UVa interventional cardiologist and by opening an internal medicine practice in Crozet.

A UVa official said he would have preferred if Augusta Health hadn’t made those moves.

Eight months later, UVa added a “non-competition” clause to employment agreements that prohibits some clinical faculty from practicing medicine within a 50-mile radius for one year after leaving. Augusta Health is a 32-mile drive from UVa.

Augusta Health CEO and President Mary Mannix did not return calls seeking comment for this story Thursday.

The three affected doctors have worked without an agreement with Augusta Health since their previous one expired in March.

Costabile said the agreement included cardiology care, as well as pulmonary critical care and infectious diseases care.

UVa has leased office space across from the hospital so the cardiologists can continue to see their patients.

“Our plan is to continue to deliver care in Augusta County,” Costabile said.

Cardio-logist Max Luna, one of the three doctors, said he would be unable to provide emergency care at Augusta Health should a patient have a heart attack.

The doctors won’t be able to monitor procedures the patients may have done.

Luna said he and his colleagues have appealed their decision to the hospital board.

A final decision is due in the next two weeks, but Luna is not optimistic.

“My passion is clinical medicine and this is an enjoyable place to work with patients and colleagues,” Luna said.

He said Augusta Health nurses and medical staff supported the doctors remaining on staff.

Luna said he has also worked at community hospitals in Louisiana and Massachusetts, and said those hospitals allowed multiple cardiac groups to practice.

In his statement, Crow said the hospital now has the capability of caring for acute heart attack victims on an emergency basis.

In addition to the hiring of doctors, Crow said the hospital has opened “a state-of-the-art cardiac catheterization suite.”

He said Augusta Health has achieved an average of 40 minutes to restore blood flow to a victim’s heart with the use of a stent, well below the recommended maximum time.

Luna said his sense is that the hospital is cutting ties for financial reasons, not because of dissatisfaction with the care he and his colleagues offered.

“They need to cover their expenses,” he said.

When announcing the cardiac facility and hiring of cardiologists in January, Mannix said area residents need 24-7 access to care for the country’s leading killer.

Patients of the affected doctors worry about commuting to Charlottesville for procedures.

Larry Monroe of Waynesboro, a patient of cardiologist Jaime Escanellas for 16 years, had to reschedule a cardiac test from Augusta Health to UVa for next week.

Monroe, 77, called the development “rather foolish.”

“This board of directors and this administrator are putting people in jeopardy,” he said.

Wayne Moe, a 90-year-old Augusta County man, is also a patient with Escanellas.

He said a drive over Afton Mountain “is very inconvenient. I can be in his [current] office in 10 to 15 minutes.”

With the change, Moe said there will be a longer drive plus having to check into UVa for any heart-related tests.

The third UVa doctor affected is cardiologist John Zadrozny.

Bob Stuart reports for the (Waynesboro) News Virginian.