The creation of Health Sciences North's new Cardiac Out-Patient Centre has created a schism among the city's nine cardiologists and has instigated an external review.
Dr. Clyde Hourtovenko, a cardiologist with a practice located at 65 Larch St., challenged hospital administrators about the new outpatient centre during Health Sciences North's annual general meeting Thursday night.
Hourtovenko said the hospital did not consult with him and other cardiologists when it decided to establish the centre, and said during a question-and-answer session it has decreased morale among cardiologists.
Now, Dr. Roger Labonté, the hospital's chief of cardiology, is saying he only found out about the centre — from hospital technicians, not administrators — last summer.
While he has monthly meetings with hospital administration, Labonté told Sudbury.com he was never consulted about the centre. What's more, he said the hospital's cardiology outpatient centre has created a two-tiered system for the region's cardiologists.
Part of cardiologists' incomes come from fees they receive from the province when they read and interpret various tests like echocardiograms.
Cardiologists in the Nickel City all have their own clinics, but are also referred a large number of tests from the hospital. In return for those referrals – which are placed in a pool and divided evenly among the nine doctors – they each put in hours treating patients at Health Sciences North.
Labonté said the hospital referrals (which come from primary care providers throughout the region) are invaluable for new cardiologists who have not yet established their own patient rosters.
“Ninety per cent of the time family doctors will refer their patients to the cardiologist who read it (the test),” he said.
But to entice four of Sudbury's cardiologists to move from a clinic on Long Lake Road to the new Cardiac Out-Patient Centre, located at the former Memorial Hospital site on Regent Street, Labonté said the hospital cut a deal with those doctors to give them a greater share of their referrals.
The cardiologists would generate more income from those referrals, which would help subsidize their rent at the new site.
Labonté said the hospital already has a shortage of cardiologists and added he fears the uneven distribution of hospital referrals could push some to just focus on their own private practices instead.
“If that happens, we'll be in a crisis,” he said.
While the Cardiac Out-Patient Centre has room to attract two more cardiologists, Labonté said after they have filled that quota new cardiologists might avoid Sudbury, since they would be at a competitive disadvantage.
“I think if you take a step back, you realize there are conflicts of interest on both sides,” Dr. Chris Bourdon, the hospital's chief of staff, said at the hosptial's annual general meeting. “The fear is only the cardiologists at the clinic will have access (to the tests) but that was never the intent. That was certainly never my intent.”
Bourdon said an external review, which will be conducted by a physician from the Toronto region without any affiliations to Health Sciences North, will determine if the hospital created a conflict of interests with the Cardiac Out-Patient Centre.
But Bourdon added the hospital is not concerned with the care provided at the centre, or by any of Sudbury's cardiologists.
While the review can make recommendations to Health Sciences North, none of its findings will be binding, or have any legal weight.
