Longtime surgeon questions conditions at UMC

A longtime Lebanon physician has very publicly criticized University Medical Center for questionable conditions in its "basement" surgery facilities, including allegations of hatching insects and machine exhaust.
Amid a certificate of need (CON) battle between two of the nation's largest hospital corporations – UMC parent company Health Management Associates (HMA) and Summit Hospital parent company Hospital Corporation of America (HCA) – Wilson County doctors in public records obtained by The Lebanon Democrat state their support for a new Lebanon-based Summit surgery center.
In sounding their endorsement for the Summit facility, Wilson County doctors also took to task costs and conditions at UMC. Chief among those was longtime local orthopedic surgeon Dr. Stephen Neely who appeared to question conditions at UMC's surgery facilities.
"Today we practice our day surgery, ambulatory surgery in a basement, the victim of smelling the exhaust from the lawn mowers (sic) when they cut outside, uncontrolled humidity at times and actually an occasional insect hatching," Neely wrote in a Nov. 19, 2004, letter to the state's certificate of need board, the Tennessee Health Services and Development Agency (THSDA).
UMC CEO Mark W. Crawford responded by noting the hospital was last surveyed by state health officials Dec. 17 and was not cited for any deficiencies.
He added the hospital is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The last JCAHO survey was completed in June 2002 and "current status is accreditation with full standards compliance as of Jan. 14, 2003," Crawford said, noting UMC's evaluation score was a 94.
"University Medical Center strongly supports patient satisfaction and service excellence through our Expect Excellence program. In this program, UMC ranks in the 96th percentile in comparison with our peers," Crawford continued, referring to Neely's comments as unsubstantiated. "We've been inspected, accredited and there is nothing to support these bizarre statements."
Neely, a physician with Tennessee Orthopedics, was one of at least three local physicians who wrote letters supporting Summit's plans for an $11 million facility near the Hartmann Drive Interchange, citing concerns with UMC ranging from the hospital's location to its appearance.
Other doctors supporting the Summit project also revealed they will have the opportunity to buy an ownership interest in the new HCA financed facility.
UMC administrators said Tuesday they will fight the Summit application, saying the larger hospital company is trying to "cherry pick" paying customers from the community hospital.
" … the physicians that are writing these letters are going to profit from the patients that they are taking from University Medical Center," Crawford said. "Therefore, they are motivated to make their case as aggressively as possible."
Dr. Dwayne Lett, chief of surgery at UMC, said Wednesday he had not experienced any of the problems listed by Neely in the hospital's surgery facilities and questioned why any physician who had noticed such deficiencies would continue to see patients there.
"My experience is that I would not ask my patient to have a procedure if I didn't feel the facility met the standard of care for the community and for the region," Lett said.
Any deficiencies that do exist at UMC, he continued, are the result of a "lack of attention" given to the hospital by its previous owner, Tenet Healthcare Corporation.
Since acquiring the Lebanon hospital in 2003, Naples, Fla.-based HMA has made and continues to make numerous improvements to the facility, Lett added.
"To improve anything or to develop a culture of progress – which I am seeing and hope to continue to see – will take time and requires patience from the medical staff and the community," he said. " … I feel comfortable bringing my patients here."
Neely was unavailable for further comment Wednesday.
The CON battle with Summit appears to have pitted the Lebanon hospital against many of its own doctors, including Neely's large, multi-physician practice.
According to published reports, hospital officials have said they will fight another CON, this one against the county's other orthopedic doctors group – Tennessee Sports Medicine – who are trying to build a facility in Mt. Juliet. UMC Director of Marketing and Communications Anna-Lee Cockrill could not confirm those plans Wednesday.
Another local doctor who backed Summit's plan, Tennessee Orthopedics' Dr. Douglas Freels told state health officials he believed the new outpatient surgery center's planned location would better suit the needs of residents from Wilson and surrounding counties.
"I think that there is a large percentage of patients in Wilson County who have the perception that the quality of care in that facility (UMC) is determined by the overall aesthetic appeal and outside appearance," Freels wrote in a Nov. 16, 2004, letter to THSDA officials. " … It is my feeling that because the hospital has failed to upgrade and make their facility an appealing facility to the general public, then the physicians are somewhat encumbered by the hospital."
However, like Lett, Dr. Roger McKinney – a physician with UMC for the past 26 years – explained HMA has begun upgrading the hospital's appearance and capabilities but stressed such improvements could not be made "overnight."
"I look at a hospital like I look at a church," McKinney said. "The building is not the hospital, and the church building is not the church. The hospital is the doctors. We have a very good group of doctors, and we try to practice good medicine. I think we do a good job."
Staff Writer Brian Harville can be reached at 444-3952 ext. 16 or by e-mail at brian.harville@lebanondemocrat.com.