Money to be made

You would do well not to have heart surgery – either for a Congenital Heart Defect or an acquired Heart Problem – in Central South Carolina.

Before you understand why, I need to explain the basic geography: In Columbia, South Carolina are several hospitals, but there are two of interest: One of them is Providence, which bills itself as the state’s heart hospital. Most of the procedures they do are for acquired heart problems – catherizations, bypass, stent placement… that’s their specialty. (I’ve been a patient there, They are very good at what they do, but when you are talking about Congenital Heart Defects, not so much.) There is another hospital nearby, Palmetto Health, that also performs heart surgery. Like “the state’s heart hospital”, they also do mainly procedures that you associate with acquired heart problems.

Think about that: two heart surgery hospitals in a city with less than 200,000 population. Wow. If you ask them, they need all these heart surgery options because the hospitals are centrally located and serve most of South Carolina, which has a population of about 3 million people. (Most CHD surgery is done at the Medical University of South Carolina, located 200 miles away in Charleston.)

Now look across the county line, at Lexington Medical Center. Lexington Medical wants to start performing heart surgery. They want it bad – so bad, that two years ago they went to South Carolina’s state health organization (the Department of Health and Environmental Control, known by their acronym, DHEC) and requested permission to start a heart surgery unit.

DHEC (pronounced “Dee-Heck”) said no. There’s plenty of heart surgery options available across the county line in Columbia, and they aren’t really far away. We don’t really need a third heart surgery center that close to the other two.

Now what could prompt Lexington Medical to want to start a surgical unit? Greed. Heart Surgery can be a cash cow for a hospital. There’s money in them there Ventricles, and gosh darn it, we should claim our fair share!

So after DHEC turned them down, Lexington Medical limped off to nurse its wounds, but was soon back with another plan. If they could convince DHEC to reduce the minimum number of heart operations needed to qualify as a surgical center, they could get their Heart Surgery unit!

Are they out of their freaking minds?

If you want to become proficient at something, you do it… and keep doing it until you get good at it. This is especially true with heart surgery: patients fare better under the care of more experienced surgeons and hospitals. But Lexington Medical wanted to lower the number of procedures required. Thankfully, DHEC shot this idea down, too.

But once again, Lexington Medical is back – this time, they have convinced Providence to shut down one of their heart surgery units while Lexington Medical opens the Open Heart Surgery unit so have wanted so badly. In return, Lexington Medical will pay Providence fifteen million dollars.

Are they out of their freaking minds?

The answer seems to be yes – not just at Lexington Medical, but also over at Providence, too. And at DHEC for agreeing to this crazy scheme. A surgical unit (of any specialty) can not be purchased at Hospitals R Us – they have to be assembled, person by person, one team member at a time, until you have an experienced unit that works well together. That could take ten to fifteen years.

Obviously, money is a big factor in any medical program. But Lexington Medical Center has pursued their new open heart surgery center not to serve the community, but in pursuit of the almighty dollar.

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2 Responses to “Money to be made”

  1. Michelle Says:

    That is really unbelievable. The good thing for CHD patients in central SC is that just across the river in Augusta, GA is the Children’s Medical Center at MCG. Our son had ohs for TOF in 2007 and they have a phenomenal children’s heart program.

  2. Chris A Says:

    I am wondering if you have ever read a book titled “Walk on Water” by Michael Ruhlman? It is subtitled ‘Inside an Elite Pediatric Surgical Unit.’ It is a very interesting, amazing book in many ways…it is also disturbing. It is written by a man who had no experience at all with CHD. He spent a year with Dr. Mee at the Cleveland Clinic. One of the disturbing things Mr. Ruhlman discovered was that even though Dr. Mee who was considered, at the time, to be one the top experts in the US and very possibly the world in repairing Transposition of the Great Arteries many babies born with that defect in Ohio were not being referred to Dr. Mee. In an afterward written by Mr. Ruhlman on his website (although I do not beleive it is there now) he mentioned with frustration and heartache for heart families, that IF his child who was born in a hospital across the street from the Cleveland Clinic had been born with Transposition they would NOT have been referred to Dr. Mee. They would have been referred to the surgeon with much less experience and success at the hospital where their baby was born… not knowing any better and trusting the doctors in a very frighteeing, vunerable time they would have agreed to the surgery.

    I am the parent of a 21yr old and a 17yr old with CHD. We need to constantly do our homework to learn who the experts are, we need to ask questions and send records for second opinions.

    I learn so much from your blog.

    Thank you for writing every day.
    Thank you for writing this article.

    with Hope,
    ~ Chris A ~

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