FINAL PLANS FOR IMPLEMENTATION UNDERWAY Plans were begun Friday, the day after approval was received for the implementation of the cardiovascular surgery program at DMGH. Intensive efforts for initiation of the CV surgery program were begun over six months ago and culminated in the surgery planned to occur in late June. A Board of Trustees' decision was made, however, to delay that surgery (in part at the request of the Healths Systems Agency) and proceed through the planning process to seek approval. Since that decision, efforts have continued to further prepare for surgery. Mr. Tate indicated that a series of steps, meetings, and final preparations are now underway and will occur over the next several weeks. The final, necessary piece of equipment - a heart/lung machine - has now been received, and the remaining efforts are for the establishment of protocols and the coordination and final preparation of the team. Mr. Tate stated that "various 'rehearsals' and trial runs will occur with the final preparation being a detailed review of everything that will occur from the time a patient is admitted until his discharge." Plans call for the first surgery to be performed within 30 days. A MAJOR PRECEDENT Over a year ago Des Moines General, along with the Polk Co. Society of Osteopathic Physicians and Surgeons, undertook efforts to have included in the Certificate of Need law a provision which protected the osteopathic profession and the freedom of providers and patients to choose between osteopathic and allopathic medicine. That effort was successful in including such a provision. The cardiovascular decision reached last Thursday was the first real application of that provision of the law. The CON Council approved the CV surgery project and thereby recognized the appropriateness of having osteopathic need as a legitimate, unmet patient need. It also recognized that the law must be applied, as it so clearly states, in such a way as to protect the freedom of choice between these two distinct medical philosophies. Although it may be months or years before the full impact of this decision is known, it is clear that this is a decision that is of critical importance to the osteopathic profession in lowa and perhaps the country. Other issues and decisions will come along that will more clearly and definitively define the application of the CON to the osteopathic profession, but this decision is clearly an outstanding first decision in this issue. This is in response to your Mailgram of September 1, 1976, regarding In 1974 Art Centre Hospital filed for a Certificate of Need to replace its We are currently in the process of appealing this in the Circuit Court. Should you have any questions regarding this matter, please do not hesitate to contact me. Mr. Oshinsky has given me your letter of December 5, 1977. I have taken the liberty to enclose some of the arguments we intend to present to our local HSA regarding the discriminating national health planning guidelines. As far as personal discrimination is concerned, I was twice turned 1972. During the process of these applications, I met with the application The physicians that have been accepted at Weld County General Hospital Briefly my background is as follows: 1. Born and raised in this same community. 2. In highschool, my grades were in the upper 10% of my class and I was involved in athletics where I received an award for the 3. I was accepted to the University of Michigan and had an athletic 4. While attending the University of Michigan, I was number three in 6. I was accepted at the Los Angeles County Osteopathic Hospital for 7. Following my internship, I was accepted in one of two general 8. On completion of my residency in general surgery at Long Beach 9. During the eleven years of practice, I was accepted as a member 10. Following acceptance in the American College of Osteopathic Surgeons, 11. Following being turned down at Weld County Hospital, Dr. John Grow In conclusion, I apologize for having to list some of the places where I have excelled over the years but it is difficult to establish any kind of discrimination unless you know something about the individual you are discribing. I hope this is helpful and I would be glad to help you in any way that I can. Sincerely yours, Miles D. Lee, D.O. ck Enclosure December 28, 1977 The Honorable Frederic A. Grimm 3278 Roosevelt Road Apartment T-10 Muskegon, Michigan 49441 Dear Judge Grimm: THE GRAND RAPIDS A non-profit community teaching hospital Recent action of the West Michigan Health Systems Agency Board with serious potential Impact on Grand Rapids Osteopathic Hospital prompts this letter. It is our understanding that a motion was defeated 14 to 13 on the question of allowing an Osteopathic Hospital obstetrical service to be exempted from the proposed Health Systems Agency goal of 1,500 minimum deliveries per year in population centers of 100,000 or more. A letter from Mr. McCarthy, our President, had drawn your attention to the fact that strict Interpretation of that goal could close all but one osteopathic obstetrical service In the entire United States (actually, there are two hospital corporations which could meet this goal; however, only one is a single, unitary Institution); this purely on the basis of arbitrary numbers and with no objective analysis of comparative cost or outcomes in terms of successful deliverles of healthy Infants from healthy mothers. This also, despite the fact Grand Rapids Osteopathic Hospital has demonstrated mortality, morbidity and length of stay statistics equal to or better than most centers that deliver In excess of 2,000 bables a year. (See Michigan Department of Public Health "Perinatal Mortality By Hospital Birth, Michigan 1970-72" as distributed June 23, 1975.) We are hospital number 133 In this study. The HSA Board members should be aware of the Impact on services to this community should It propose to force closure of the obstetrical unit of Grand Rapids Osteopathic Hospital. 1. Closure of the postdoctoral training program for Interns. A rotating Internship In an AOA approved osteopathic hospital is required for osteopathic practice licensure In Michigan. An AOA approved program requires obstetrical experience in an osteopathIcally oriented Institution. Our Internship program currently is training 14 Interns, many of whom will become family practitioners In the West Michigan area. These Interns would be deprived of exposure to the treatment of newborn Infants as well as the management of obstetrical delivery. The only way an Intern program could be continued In the absence of obstetrical service at Grand Rapids Osteopathic Hospital would be to send osteopathic Interns to another osteopathic hospital which would meet the volume requirements of the HEW Guidelines. The one such osteopathic hospital in the country obviously cannot provide such training programs for the 1,000 D.0. graduates expected in 1978 and In future years. 1919 boston st., s.e../ grand rapids, michigan 49506 / phone (616) 452-5151 |