Enough Clinic...for now.

I don't think I've ever elemented a comment to a post before, but I thought this one was well-written and, well, I have depositions today so will be otherwise disposed!

I am a Clinic physician. I have seen the letter that was sent to Dr. Garver's patients. I am not in the least bit embarrassed by the letter. I can say without reservation that I am proud of the way Dr. Garver's departure has been handled by the Clinic.

It is fair to say that there is always more to the story when a physician leaves his practice. I do not feel it is appropriate to comment specifically about Dr. Garver. But in general, when a physician leaves the Clinic we have a moral and legal obligation to notify his patients. We have no obligation to "candidly" comment on the reasons behind his departure. In fact, I would go so far as to say we should not comment on confidential reasons for a departure, as the truth would very often make the departing physician look bad.

About 10% of physicians will change practice in any given year (A.M.G.A data). Physicians with the Clinic, as well as independent physicians in Great Falls, change practice less than the national average. Often this move is secondary to compensation issues.

(As an aside, most of the physicians who have left the Clinic, yet stayed in town, make more money on their own then they did as partners. The reasons for this are beyond the scope of today's post, yet dovetail nicely with recent threads voicing baseless concerns about financial incentives for self-referral, etc.).

Others leave for geographical reasons, family obligations, etc. In each case, a letter is sent to every patient in the Clinic database who is linked to that physician. Occasionally we will announce why a partner is leaving (academic appointment, retirement, etc.). Yet most of the time it is simply a letter announcing the departure, in order that the patient may arrange for continuity of care with the departing physician, or within the Clinic if they so chose.

The individual physician may choose to send a letter to his patients announcing his new practice location, or more likely will take out an ad in the Tribune. The Clinic will even provide a departing physician with the names and addresses of his practice panel at no cost (and with no hassle). For example, when Dr. Mungas left the Clinic, he both mailed a letter and took out an ad.

I still fail to see the relevance of this article. I don't want to belabor the point, but this was sensational journalism on par with a tabloid. It is not front-page news. It doesn't even warrant a mention in the business section in my opinion. So a doctor is moving. It happens every month. I don't remember a similar outcry when Dr. Garrity left independent pediatric practice to join the Clinic.

Although I have no independent knowledge of Ms. Cates motivations, I can guess that she or the Tribune was contacted either by Cherish Aldridge’s father, or more likely by Dr. Garver's attorney. I am not familiar with Ms. Cates, so I can’t comment on her body of work, other than to say this article was poorly researched, full of errors of logic, and designed solely to cause harm to the Clinic’s reputation. Yet as poor a reporter Ms. Cates may be, where was her editor in all this?

Does anybody realize the harm articles like this can cause a community? Recall that second to Malstrom, healthcare (Benefis plus the Clinic) is Great Fall’s largest employer. Recall that the Tribune is widely read across north central Montana. Every time one of these articles appears, it drives patients to Kalispell, Missoula, and Billings for their care. We can have all the economic development experts in the world at the Chamber of Commerce or BID, and they won’t have a fraction of the (positive) influence that articles like this have (in the negative). Again, what were Ms. Cates and her editor thinking? Bad news is better than no news?

I too wonder how Clinic physicians and staff suffer silently with the slanderous P.R. war being raged by Benefis via the Tribune. I usually take a deep breath, and reaffirm my belief that it is below us, as professionals entrusted with the health and well-being of individuals in this community, to lash out. We have a history of taking the high road, and I think that it has served us well to date. Recall when the Tribune printed letters from the E.R. and anesthesia groups accusing Clinic physicians of cherry-picking? Well, it was a struggle for me to stay silent. Yet over the ensuing weeks, I had countless patients tell me that they were proud of the Clinic for acting professionally, and staying above the fray.

Remember, a hospital doesn’t take care of patients, doctors and nurses do. You see, Clinic physicians take care of all comers, regardless of ability to pay. We take call, so that Benefis can run an E.R., and field a level IV trauma center. Geeguy, you are right, when a patient can not pay their E.R. doctor, or their anesthesiologist, it goes without saying that as their surgeon I don’t get paid either. I simply feel privileged to provide emergency care to members of this great community.

I suspect that the majority of people in town don't realize how good healthcare is here. I trained at major institutions on both coasts. There is very little that can be done at an academic medical center that we can't do here. In my opinion, we have incredible physicians, support-staff, and facilities in Great Falls. I am proud to be a member of this health-care team. I only wish the Tribune would take similar pride, and foster a positive take on healthcare issues in Great Falls.

Response here.