A skirmish in the war against disease

CHAMPAIGN – Christie Clinic's new cancer center is set to open Monday in downtown Champaign, but a nearby hospital with a cancer center of its own says it's going to be hurt substantially by the new competition.

David Bertauski, chief executive of Provena Covenant Medical Center in Urbana, said Covenant will lose $1.5 million in annual revenue to Christie because the clinic won't send radiation therapy patients to the hospital for treatments.

"That is substantial," Bertauski said. "I find it particularly disconcerting when our partners, our medical staff, have made a decision to compete with us. It's really kind of transformed the way we think, the way we do business."

Christie's new facility – built on part of its parking lot at a cost of $5 million – will offer radiation therapy treatments only. Chemotherapy services will remain in the main clinic downtown.

Christie officials said they want a radiation oncology facility of their own to bring convenience and the latest technology to their patients.

And building it close to the main clinic was especially important for a new cancer treatment protocol the clinic is using that specifies radiation and chemotherapy be administered on the same day, 15 to 30 minutes apart.

Dr. Gary Schultz, Christie's radiation oncologist who also sees patients at Covenant, said this protocol produces a much higher cure rate: 85 percent to 90 percent for stage one and stage two cancers, and 30 percent to 40 percent for stage three and four cancers.

As for the convenience factor, Christie patients and doctors will have all their doctors, treatments and lab work available at one location, said Robert Holbrook, Christie's senior director of ancillary health.

"No more kind of a fragmented network," he said.

The new cancer center is in a 4,300-square-foot building and is expected to serve 25 to 30 patients a day. Holbrook and Schultz said it was built with the latest in radiation containment construction. It also offers state-of-the-art treatment technology, including intensity-modulated radiation therapy that delivers a highly precise dose to a tumor while sparing surrounding healthy tissue, Schultz said.

But Bertauski said Christie easily could have used its new treatment protocol by administering both chemotherapy and radiation at the hospital.

So why the tug of war over cancer patients? Both radiation and chemotherapy are money-makers for medical providers, Bertauski said.

"I understand why Christie makes these decisions, and I can't quarrel with that. But we have to make our decisions accordingly," he said.

Those decisions involve drawing a new line in the sand: Bertauski said from now on, Covenant will do what's best for its own business without consideration of what's best for the clinic and its doctors.

And right now that means supporting the community's independent physicians – who view Covenant as a partner and not as a commodity, he said.

Christie Clinic Chief Executive Alan Gleghorn said he understands why Bertauski would feel that way because Christie Clinic puts the choice of hospitals in the patients' hands and no longer sends patients automatically to Covenant.

"Provena Covenant is an integral part of what Christie does because it's where we render hospital services, but we believe in the patients having the choice of hospital service so we also include Carle in our business plan as we include Provena Covenant," he said.

In keeping with its patient choice approach, Gleghorn said, Schultz will continue to offer radiation oncology at both Christie and Covenant, "so we are not taking all the patients out of Provena.

"We understand that Provena Covenant offers radiation oncology. Provena Covenant also offers other services that Christie offers," he said. "Christie has put in this radiation oncology center based on our patients' needs and based on how we perceive cancer treatments should be administered on one campus."

Christie invited Covenant to be a partner in its new radiation oncology center, but the hospital declined because it wasn't in its best interests, Bertauski said. Covenant is upgrading its own radiation oncology department and technology this year.

The hospital soon will have technology just as state-of-the-art as Christie's, Bertauski said. Covenant also will hire a new radiation oncologist and place new limits on Schultz's privileges at the hospital.

Bertauski said all this underscores the need for the state to continue its oversight process for new medical projects to avoid expensive duplication of services in the same community. Christie's new cancer center was below the threshold for the state's Certificate of Need oversight process, and now Champaign-Urbana has three providers (including Carle Clinic) offering radiation within a short distance of each other, he said.

"Typically, hospitals and the medical staff work together as partners, and typically there is a synergistic relationship between both parties," Bertauski said. "And usually, what you see is medical staffs want the hospitals to be profitable because hospitals can then, in turn, provide them with the latest technology with all the bells and whistles."

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