Health care turf war: Wilson Medical Center challenges Vidant’s Wilson healthplex plans

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While Vidant Medical Group has a significant presence across eastern North Carolina, the first incursion into Wilson County is under construction and Wilson Medical Center was among those taking issue with the project.

“I do believe there is some element of duplication of services from a pure health care cost standpoint and how we rationalize services within a given market and that is important,” said Wilson Medical Center CEO Bill Caldwell. “There is enough gaps and questions with their application about what this will look like a year from now, so this was an opportunity for us to share some of our observations about the project itself and how they will integrate with the medical community here.”

The majority of the $14 million Vidant Healthplex-Wilson is not subject to public review, but the Greenville-based company was required to file a certificate of need application through the N.C. Division of Health Service Regulation since the expenditure on diagnostic equipment exceeded $500,000.

“In November, we could open with $499,999 in equipment, but one extra piece over that limit is where the certificate of need kicks in,” said Jeff Shovelin, administrator of corporate planning for Vidant Health. “...If we put in a cardiology office with equipment, a primary care next door and next door something else, we’d come nowhere near that $500,000 mark, but this is an issue because we’re putting it all in one unit.”

In April, Vidant filed the application, which is available for public review until Sept. 28. The full document is not available from the state in a digital format, but a copy can be reviewed in Raleigh or at WilsonTimes.com. Caldwell reviewed the document in May and submitted seven pages of comments about the application, questioning whether the need exists for a diagnostic center, whether the facility will be adequately staffed and whether it will be financially viable. Visit tinyurl.com/y6vd2m72 for Caldwell’s review along with information about filing comments.

“(Vidant) does not provide any narrative or assumptions regarding how it projected the clinical staffing levels, or how it links the clinical staffing levels with the projected medical diagnostic procedures,” Caldwell wrote in his review of the Vidant application. “This is meaningful because (Vidant) projects some of the diagnostic equipment procedures to increase significantly during the initial three project years. Thus, it is questionable as to if (Vidant) has reasonably shown evidence of the availability of health manpower for the provision of services to be proposed.”

Vidant officials submitted rebuttals to the points Caldwell raised, noting Wilson Medical Center “did not provide any opposition or information related to any other issue related to unnecessary duplication.”

“This healthplex, in our minds, really represents a unique opportunity to elevate the care being provided within the community while adding additional access to care and (reducing) the need for primary care patients to travel outside of Wilson to receive care,” said Todd Hickey, chief clinical network development officer for Vidant Health.

Caldwell also noted the lack of letters of support from physicians within the application, but Shovelin said that seemed unnecessarily antagonistic.

“To include letters of support means we’d have to ask local providers to choose and we found that put them in a bad position. Many physicians support this project, but didn’t want to have their names put in a public document,” he said. “We could use patient letters as well, but they would likely speak for us and against Wilson Medical Center, which we didn’t feel was important. We value what Wilson physicians and Wilson Medical Center does. ...We felt the application and the health disparities meant we didn’t need to include the letters.”

The 132-page application does mention one doctor hired for the facility. Dr. Sunny Darji will be a practicing physician at the healthplex and serve as the medical director. A search of the East Carolina University Brody School of Medicine staff directory reveals Darji is a third-year resident.

“When you get to your third or fourth year of residency, you still have growth and experience to gain, but you’ve been through a lot already,” Caldwell admitted.

Vidant officials said Darji will have significant support and not carry the leadership load alone for the facility.

According to the application, the first phase is slated to open in November and include eight primary care providers, two cardiologists and one: pulmonologist, gastroenterologist, dermatologist and neurologist. There also will be an endocrinology clinic four days a week through ECU Physicians and a neurosurgery clinic one day a week through Vidant Neurosurgery in Greenville. Vidant officials said recruiting for staff is underway with an estimated 10 providers already signed on to the project.

“Opening and managing clinics and recruiting are core elements of what we do,” said Dan Drake, senior vice president of operations for Vidant Medical Group. “In terms of recruitment efforts, I don’t anticipate any difficulty based on our capability and other clinic work we do in other locations.”

Caldwell said he’s interested to see how the Vidant providers integrate and cooperate with the larger medical community in Wilson.

“We’re supportive of some of the things Vidant is doing, especially across the region and serving some of the underprivileged, medically under-served populations,” he said. “One of the things that is important to us is when they do that, are they a part of the medical community, are they getting staff privileges at the hospital or providing emergency call coverage so they can follow their patients? I really didn’t see that in the application.”

Vidant officials said the healthplex concept rests upon the continuum of care by having primary providers, diagnostic testing and specialists under one roof.

“The healthplex will be uniquely designed to reduce wait time with hours seven days a week. The lab work will help to make sure there is a quick diagnosis and allow for plans to help treat illnesses or diseases,” said Hickey. “We’re looking to partner with others in the community to build out a system of care.

“This really is going to be a wonderful facility that adds health care, creates new jobs in the community and I really see it being very much a community benefit to Wilson.”

In his statement to state project analyst Jane Rhoe-Jones, Caldwell requested a public hearing about the healthplex. That hearing was held on June 12 in the Wilson County Board of Commissioners chambers with Caldwell, Hickey and several physicians expressing their thoughts on the project.

“We want to have good working relationships whether it is with Vidant, UNC or whatever. It is all about how to improve the health of the community and that is not just for Wilson, but for all of eastern North Carolina,” Caldwell said. “We’ve got some under-served sections of our population and if this can help with that, great. If they are supportive of the hospital, but also the larger medical community, then great.”

Vidant officials said construction is on schedule with crews expected to finish work in October. The initial phase of the healthplex is slated to open in November with the full diagnostic center debuting in February.

The certificate of need application will have no affect on the November opening, but the decision anticipated in October could jeopardize the next phase. Caldwell said once the state decides about the diagnostic center, an appeal could be lodged.

“In the world of certificates of need, this is a lower one,” he said. “They are not asking for a new hospital or new operating rooms or anything. If there was such a thing as a basic certificate of need, this is it.”

Vidant plans on having an employment event in the coming months to fill the remaining positions. For patients interested in services at the healthplex, officials ask Wilsonians to call 1-855-MYVIDANT for more information.

“We’re really excited,” said Drake. “We’re excited that we have providers coming on board and other staff as well. We’re ready to turn this on and deliver a high quality of care for patients in Wilson.”