OSF-Christie signs1

A sign in an exam room at Christie Clinic at the Fields informs patients about hospital availability.

URBANA — As abrupt as it may appear to be, a falling out between Christie Clinic and OSF Heart of Mary Medical Center began soon after Peoria-based OSF HealthCare bought that Urbana hospital in 2018.

Christie Clinic leaders described multiple clashes with OSF over business practices and patient-care issues that led 67 doctors and other providers at Christie to resign from OSF Heart of Mary’s medical staff, mostly in the past year.

According to Christie Clinic CEO Kenny Bilger, many attempts to resolve differences with OSF have failed, and he now considers the rift to be permanent.

“This will not be resolved,” he told The News-Gazette. “We’ve moved so far on.”

Patients are free to make their own hospital choices, but when their doctors aren’t part of a hospital’s medical staff, they can’t admit their patients or provide care for them there.

Some Christie providers, among them those in general surgery, obstetrics and ophthalmology, are still working with OSF Heart of Mary. But many Christie physicians — especially specialists — aren’t.

To make sure patients are aware of that, Christie Clinic recently posted signs at its facilities informing patients who will be needing hospital care that they won’t experience an interruption in their relationships with their doctors if they’re hospitalized at Carle, according to Bilger.

“Patients and their physicians ultimately decide which hospital facility to seek care at,” Bilger said. “If they would like the care of a Christie Clinic physician, we want to get them to a facility in which the Christie Clinic physician is on staff. The vast majority of Christie Clinic doctors happen to be on the medical staff at Carle only now, where our physicians always remain involved as part of our patients’ care team.”

Enter OSF

OSF HealthCare entered the local market in February 2018 when it bought two hospitals formerly owned by Presence Health — the former Presence Covenant Medical Center (now OSF Heart of Mary Medical Center) and the former Presence United Samaritans Medical Center in Danville (now OSF Sacred Heart Medical Center).

Christie Clinic and OSF leaders met numerous times between August 2017 and September 2018, with a major disagreement arising over conflicting business models, according to Bilger.

He and Christie Chief Operating Officer Jason Hirsbrunner said Christie Clinic objected to what they called OSF’s “spoke-and-hub” model that calls for some local patients to be transported out of the community to OSF facilities in Bloomington and Peoria when that care is available locally — for example, at Carle’s comprehensive stroke center.

“Christie Clinic administration and neurology physicians met with OSF on August 22, 2018, to discuss stroke services,” Hirsbrunner said. “OSF acknowledged stroke services existed in our community locally but explained their intended process would be to transfer patients by air and ground to Bloomington or Peoria, even over the objections of the Christie neurologists.”

For that spoke-and-hub model to work, physician participation is necessary, Bilger said, and “that’s not something Christie Clinic is participating in.”

Not only is sending patients out of town hard on patients and their families, he said, it also takes a certain volume of cases to recruit and retain high-level specialists in the community.

If patients are transferred out of the community, it makes it more difficult for local medical providers to sustain those services, he and Hirsbrunner said.

“Our patients have continuously expressed their desire for local care, and we will provide care to our community and in our community,” Bilger said.

Trust gone

Bilger said Christie Clinic doesn’t have a problem with competition, “as evidenced by our 80-plus-year very healthy competition with Carle.”

But, he and Hirsbrunner contended, OSF leaders repeatedly violated their trust — in part by indicating to Christie Clinic at multiple meetings that they didn’t have plans to add outpatient services in the area, then opening four competing urgent care (called Urgo) centers in Champaign-Urbana and Danville and attempting to poach Christie Clinic’s advanced practice nurses and physician assistants.

In some cases, he and Hirsbrunner said, OSF Heart of Mary has also tried to keep Christie patients in the OSF system by noting on patient discharge instructions to follow up with an OSF physician rather than with patients’ own primary care doctors.

That doesn’t happen when Christie patients are hospitalized at Carle, which honors existing doctor-patient relationships, Bilger said.

“We had to secure a long-term hospital relationship with someone we trust,” he said.

Lost business

OSF HealthCare leaders declined requests from The News-Gazette for an interview.

OSF also didn’t respond to questions about whether it is transporting local patients out of the community or attempting to divert Christie patients hospitalized at Heart of Mary to an OSF doctor.

In emailed responses to other questions, OSF spokeswoman Libby Allison said the departure of so many Christie Clinic providers from OSF Heart of Mary’s medical staff has resulted in a substantial reduction in the number of patients at that hospital.

With fewer patients, OSF has closed a medical-surgical unit, Allison said — though, she stressed, that move doesn’t affect the hospital’s ability to care for its patients.

“There is no doubt that Christie’s mass resignations (from the hospital medical staff) have substantially reduced the number of patients seen at Heart of Mary Medical Center in Urbana,” Allison said. “As a result, we have temporarily reconfigured space and shut down those sections not in use.”

OSF works with many physician groups in a variety of ways, according to Allison.

“Generally, it is OSF’s practice to deliver to the model that best suits those physicians, the patients and the larger community,” she said. “We try to keep our patients in their local communities, which typically requires coordination with local providers. Working collaboratively with the providers in OSF’s service area is critical to OSF, and it was certainly our hope that Christie would have wanted to work collaboratively to benefit the patients in the Champaign-Urbana area.”

Christie Clinic demanded that OSF HealthCare restrict its services to the hospital without offering ambulatory (non-hospital) care services in this area, Allison said, “which we do not believe is in the best interests of the community or its stakeholders.”

OSF has been, and continues to be, happy to partner with Christie Clinic and its doctors, she said.

“Indeed we had hoped to continue the relationship with Christie that Presence had with them, but unfortunately, Christie instead chose to punish OSF for its unwillingness to limit our services in the region,” Allison said.

Different in Danville

Allison said OSF’s experience in Danville — where, she said, Christie Clinic has a limited presence — has been different.

“Sacred Heart Medical Center continues to see growth in patient volume and visits since joining the OSF HealthCare family,” she said.

Danville is a one-hospital city, Bilger countered.

“Christie Clinic Danville providers continue to refer patients to the OSF Sacred Heart facility for services because it’s located in the Danville community,” he said.

Meanwhile, Allison said OSF is continuing to invest in both the Champaign-Urbana and Danville communities.

“Any rumor that OSF Healthcare is shutting down any hospital operations or service lines are simply false,” she said.

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