The irony in the Lexington Medical/Duke deal

Something about this development perplexes me:

Now after a 10-year struggle to receive a certificate of need from the S.C. Department of Health and Environmental Control to provide heart surgeries, Lexington Medical has signed an agreement with Duke Medicine to provide cardiovascular services at the hospital.

Lexington Medical Center will affiliate with Duke’s internationally recognized heart program to begin procedures including open heart surgery and elective angioplasty at Lexington Medical Center in 2011.

Through its affiliation, Lexington Medical will benefit from Duke’s clinical expertise and services to build a comprehensive heart program. Duke University Hospital, recognized as one of the top 10 heart hospitals in the nation by U.S. News and World Report, will help recruit cardiovascular surgeons and cardiac anesthesiologists to work at Lexington Medical Center.

Duke will assist with the recruitment and training of nurses and staff, design of the open heart surgery operating room, implementation of policies and procedures as well as comprehensive oversight of quality and development for all cardiovascular services at Lexington Medical.

Marti Taylor, associate vice president of cardiovascular serviced at Duke University Health System, said Duke had been in discussions with Lexington for about six months. It currently has affiliations with 11 other hospitals from Florida to Virginia.

She said Duke comes into a collaboration with three objectives: to expand its cardiovascular services; expand the Duke brand; and to provide patients access to tertiary services available at university hospitals.

Dr. Peter Smith, professor and chief of cardiothoracic surgery at Duke University, is charged with getting the heart program up and running. He has been involved with opening six other heart surgery programs, he said…

That sounds great and all, and I wish everyone concerned the best, but I can’t help remembering… all those years that LexMed was arguing, fussing and fighting with Providence, Palmetto Health, DHEC and the editorial board of The State over whether it would be allowed to do open-heart, there was a consistent refrain we heard from folks in Lexington County, which went something like this:

Lexington Medical is a great hospital. We have the expertise to do open-heart. We’re ready to do open-heart. You people on the other side of the river are acting like we in Lexington County aren’t good enough, or smart enough, to run a heart hospital. You’re dissing us, and we’ve had enough of it.

This sentiment, oft expressed, packed the full weight of the painful identity divide that runs down the middle of our community.

Of course, we were doing nothing of the kind. We (at the newspaper, anyway, and I had no indications anyone else thought anything different) that LexMed was indeed a wonderful hospital. It wasn’t about good enough or smart enough or being ready. It was about the fact that with such procedures, a team needs to be able to do a certain number of them to be and stay proficient, and if open-heart got spread and scattered across THREE local hospitals (when it really shouldn’t even have been spread across two), NONE of those facilities are likely to be doing enough procedures to be as good as they should be.

So now that Providence quit fighting this, now that LexMed is poised to move forward… it has to call in the Pros from Dover to take the next steps?

Very ironic, it seems to me.

3 thoughts on “The irony in the Lexington Medical/Duke deal

  1. Doug Ross

    “It was about the fact that with such procedures, a team needs to be able to do a certain number of them to be and stay proficient,”

    Were you ever able to determine what the “certain number” of procedures was required in order to stay proficient? And were you ever able to prove that doctors would be sitting around twiddling their thumbs waiting on patients?

    My guess: there is ample supply of patients requiring surgery to keep surgeons proficient and anything that can be done to reduce the delay between diagnosis and surgery is a good thing.

    And you’re dinging them for bringing in experts to help speed along the process to do the best job possible? There’s nothing ironic about it. Seems like a smart move made by smart people.

  2. Mark Stewart

    I like that healthcare is now all about branding. And product tie-ins. Go Blue Devils!

    Lexington Hospital shot itself in the foot when it built way out west at I-26 back in the day. Not that they would, or could, have necessarily known what would become of the county’s growth, but a location only minutes from the Cola hospitals just didn’t seem too bright, even back then. Now the politically palatable solution of not ditching West Cola is really coming back to haunt them. But maybe not as much as the pain that the tacit acknowledgement that LexMed really doesn’t have it’s medical game down pat will bring as this news sinks into the community.

    Maybe it would have been better for everyone if they had just handed back the heart certification to DHEC.

  3. Lynn

    Funny you should mention quality being diluted, at no time during the DHEC review of LMC’s request for permission to do open heart surgery, did either Palmetto Health nor Providence provide their cardiac surgery quality data for public review. The best publicly available data on quality of care Leap Frog, Health Grades, Medicare show that for South Carolina and Columbia, our heart care is “average.” Provider perform about as expected. The good news is we don’t kill more patients than one might normally expect. The bad news is that we are “average.” (If we want above average care I guess we all head to Lake Woebegone General.)

    So looking to affiliate with Duke to provide brand cache (that’s what the advertising folks call it) seems reasonable to me.

    Small volume cardiac surgery programs can be very high quality programs as it turns out. Volume may have little to do with quality of care or patient outcomes (such a not dying or being readmitted within 30 days). Having and using a simple checklist may be more valuable. The real interesting evidence is that heart patients treated medically do just as well as patients treated surgically or with a cardiac stent.

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