The Other Nuclear Debate

May 12, 2006
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GRAND RAPIDS — When it comes down to it, how much radiation therapy does West Michigan need? Mercy General Health Partners in Muskegon wants to add the cancer-fighting technology to its stable of services. Hackley Hospital already offers radiation therapy, and says that adding competing services at Mercy General would drive up the area’s health care costs. Over the past several months, many people have shared their opinions on the future of cancer treatment in Muskegon. This week, one of the opinions that counts the most will be heard.

On Thursday, May 18, the evaluation board of the health care watchdog group Alliance for Health will make its recommendation on whether the state department of community health should approve Mercy General’s application for a certificate of need, allowing it to move forward with its plans to add a $7.8 million megavoltage radiation therapy program.

Last month, 114 individuals attended a public hearing to discuss the potential expansion of services. Several representatives of Mercy General, Hackley, and the greater Muskegon community shared their thoughts about the proposal.

Roger Spoelman, president and CEO of Mercy General Health Partners, said that the organization had performed a thorough analysis of its current programs to determine whether adding a radiation therapy program is justifiable.

“We had input from community leaders, physicians, patients and staff,” Spoelman said in a written statement submitted to the review board. “Overwhelmingly, they supported moving forward with the addition of radiation therapy services to our existing cancer program.”

But therein lies part of the problem, from Hackley’s point of view. In a letter to the evaluation board, Dr. Paul Wilson, a member of Hackley’s board of trustees, laid out the history of cancer treatment in the lakeshore community.

“Over three decades ago, in the spirit of community stewardship, Hackley and Mercy hospitals arrived at an agreement on specialty focus,” Wilson wrote. “Hackley Hospital would focus its resources on cancer — including radiation oncology — and Mercy Hospital would focus its resources on major cardiovascular services, including open heart surgery. And in the ensuing years, that is precisely what has happened — for the good of our community and for the good of our patients.”

Wilson said that the community would not benefit from the addition of a cancer program at Mercy General, which is the combined product of the former Mercy Hospital, mentioned in Wilson’s letter, and Muskegon General Hospital. In fact, he suggested that Hackley’s cancer center has more than enough capacity to support the lakeshore community’s cancer treatment needs for at least the next five years. He emphasized that point by explaining how Hackley canceled a plan to equip its cancer center with a third linear accelerator — the type of equipment Mercy General hopes to add for its radiation program. Wilson said that the community need did not merit the cost of adding the equipment. He said that the same is true of Mercy General’s plans.

“We need to ask the question: Can our community afford it? Is it the very best investment of significant resources to serve our community?” Wilson wrote. “Duplication of radiation oncology in our community places an extraordinary burden of increased costs on an already-burdened local health care economy.”

That is a point often made by the Alliance for Health. The organization has long encouraged cooperation among community “stakeholders” in order to improve health care services while maintaining low costs of operation and, in turn, low prices for the consumer. In the written recommendation from Alliance for Health staff, President Lody Zwarensteyn encouraged Mercy General and Hackley to find new ways to cooperate.

“Muskegon is best served when Hackley Hospital and Mercy General Health Partners work together closely to share and coordinate appropriate services in order to maximize cost, quality and access benefits for the greater Muskegon community,” Zwarensteyn wrote. “Closely cooperating institutions easily can maintain the nature of Muskegon as a strong medical community in West Michigan capable of independently providing most of the services needed by community residents.”

Despite the duplication of services that would occur if Mercy General institutes its new nuclear medicine program, the alliance staff recommended that the project be approved.

On Thursday, the evaluation board will take that recommendation into consideration, along with numerous other factors. Should the board concur with the staff’s findings — as it often does — the recommendation will be sent along to the Michigan Department of Community Health. State officials then have the final say in whether Mercy General will receive its certificate of need. The community health department has historically sided with the evaluation board. So, Thursday’s meeting will be a strong determinant in the future of Mercy General’s proposed program.    

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