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To the St. Luke's Family ...

By Dr. David C. Pate, News and Community
March 14, 2013

In light of recent developments and media interest, I want to share with you from my heart about where we find ourselves here at St. Luke’s and where we are going.

I’ve had the opportunity to work with many of you and get to know you over the past three years. Others I have had the opportunity to visit with at our forums and other events, and some of you have gotten to know me through the blog. 

Those who know me well will tell you that I have a deeply held faith, an unwavering devotion to my wife and family, a strong sense of right and wrong, and a passion for making a difference in health care, in Idaho if not the country.

Depending upon whom you ask, they will also say I am either smart enough or crazy enough to believe that St. Luke’s can lead the transformation of health care. 

But I am not alone in my belief. It is characteristic of St. Luke’s employees, leaders, physicians, and board members to be committed to providing the highest quality of care, in the safest possible manner, with a level of caring that is unsurpassed. I am also fortunate to work with executive and physician leadership teams that are as passionate and committed to transforming health care as I am.

As a family, we are proud of our accomplishments on behalf of those we are privileged to serve. 

This is why it is particularly difficult to accept what is going on now. I know that many of you are getting questions from friends, neighbors, and family members. It is very discouraging for me to hear and read the things we are being accused of, and to know that my family and friends are hearing and reading the same things. 

I want to share with you how I think about this, in the hopes that it may provide you with encouragement.

We are doing the right things for the right reasons. While the Federal Trade Commission can choose to believe what it wishes, we have been consistent and transparent about our plans  for health care transformation since before we learned of the investigation and before we had any idea that Saint Al’s would sue us. 

Experts nationwide have repeatedly said that care in the U.S. is fragmented, inefficient, wasteful, and too often involves low-value or no-value services. To address these problems, we are trying to provide coordinated care.

We think that these deficiencies can be partially addressed when a patient’s primary care physician and specialists have access to the same medical records, test results, and medication lists, and that we can improve care and lower costs when we work together to make sure that the patient gets the right care at the right time in the lowest-cost setting and we can prevent avoidable hospitalizations. This is what we are working to achieve with Saltzer physicians.

Our board members are leaders and business people from all the areas that we serve. Our board members represent the community. They volunteer their time on our boards and committees.  They are passionate about our mission to improve the health of the people we serve and the Triple Aim that is our strategy: better health, better care, and lower cost. 

These skilled, smart community leaders, who put their own reputations on the line when they work with St. Luke’s, simply would not be a part of any efforts to be anticompetitive or to put St. Luke’s interests above the interests of our communities. In fact, many of our board members run companies that are counting on us being successful in improving care and reducing health care costs.

St. Luke’s is rooted in the community. St. Luke’s has grown as a consequence of relationships. Communities, hospitals, and physicians have come to us asking to more closely affiliate with St. Luke’s because they felt a cultural fit. 

This cultural fit has been key to the development of St. Luke’s. Those who have joined St. Luke’s have done so because they see that we put the patient at the center of all we do, they value the relationships that they have with St. Luke’s leaders, and they feel that St. Luke’s has a strategy that makes sense for fixing what is wrong with health care and making care better and more affordable for the people of our region. 

They also like the fact that we are the locally owned and governed health system, serving our friends and neighbors in each of our communities. Decisions made by St. Luke’s are made in Idaho by people who live in Idaho. 

Because St. Luke’s is truly local, and not just the local arm of a large multi-state corporation, all revenues are reinvested in the local communities. I will share the results of a study showing the economic benefits that St. Luke’s has on Idaho’s economy in a future blog post.

Our integrity drives us to honor our commitments. We do what we say we will do. I think about the tremendous investment we made in the Magic Valley of almost a quarter of a billion dollars, nearly twice what we committed to the county commissioners for a replacement facility when the Magic Valley Regional Medical Center joined St. Luke’s. The affiliation was the subject of a ballot measure in 2006 that received an overwhelmingly favorable vote of 84 percent. 

We also made a commitment to Saltzer Medical Group. When they voted overwhelmingly to join St. Luke’s Health System, we also made commitments to them. 

I am proud that, despite the fact that Saint Alphonsus weakened the group by hiring away seven surgeons, leaving the remaining members of the group with significant financial strain, then sued us to interfere with the relationship that the group had chosen to enter, we kept our commitment to move forward with the group. 

I am proud that, despite the assault and the investigation, at a time when Saltzer would have understood if we had changed course, we kept our commitment to them and renewed our commitment to move forward in a way that would ensure their economic survival and their ability to continue to serve the people of Treasure Valley and the surrounding areas. 

It seems unfair that the physicians of Saltzer should now be subjected to a lawsuit to prevent them for working with whom they have chosen as their preferred partner, and I know that the more than 200 employees of Saltzer Medical Group are worried about how this legal action will proceed.

The irony of it all. Saint Alphonsus Health System tried to purchase the Saltzer Medical Group on more than one occasion. Saint Al’s apparently believes that it is perfectly legal for them to purchase Saltzer, but believes it is illegal for St. Luke’s to do so.

Saint Alphonsus’ complaint alleges financial ruin for Saint Alphonsus Medical Center – Nampa if Saltzer joins St. Luke’s, even though after they knew that Saltzer and St. Luke’s were working toward an affiliation, Saint Alphonsus Medical Center – Nampa announced plans for a more than $33 million expansion, including the new emergency department it just opened in Nampa. 

St. Luke’s is pleased that Saint Alphonsus is investing heavily in new facilities in Nampa that will benefit the community; it is just that no competent business would invest that amount of money if it really believed that the competition was going to put it out of business. 

The greatest irony is that Saint Alphonsus is trying to use antitrust laws, which are supposed to promote competition, to suppress it instead, turning the antitrust laws on their head by invoking these laws to protect themselves from the possibility that some of their patients might prefer their competitor’s services. 

St. Luke’s offered safeguards. We submitted assurance to the FTC and AG that St. Luke’s would not and could not use Saltzer as leverage to increase prices. Unfortunately, the FTC would consider nothing less than divestiture.

Until now, you have largely heard from Saint Alphonsus and the FTC. In court, we will have the opportunity to present our evidence and our story. 

In closing, let me say that I very much regret the Saint Alphonsus litigation, much more so than the FTC’s. It’s incredibly costly, and it grieves me that the money being spent on attorneys and paperwork could be better spent on caring for our communities, providing more health services, and providing much needed mental health and other services to those in need. 

I am very disheartened when faith-based organizations act contrary to their professed standards. And I regret the fact that, instead of our two organizations working together to improve health care, we are spending valuable time and energy on this litigation.

I have to admit that I did not see the litigation from Saint Alphonsus coming. In retrospect, perhaps I should have anticipated it. 

I have known all along that if we were to be so bold as to try to transform health care and fix what is wrong with the broken system, those who seek to maintain the status quo would fight vigorously. We have experienced the brunt of this attack. 

That fight will ultimately be futile. Health care as it is now designed is unsustainable. That is why our St. Luke’s family is willing to lead the change. The final arbiter of whether St. Luke’s is successful in transforming health care will be objective measures of population health, the outcomes of our care, and the lower premiums we believe we will be able to offer the people who choose St. Luke’s because of our success in coordinating care, managing transitions of care, managing complex health conditions, and reducing low-value and no-value services. 

This litigation is not what the community is interested in ultimately. The community is interested in being healthy. Community members are interested in health care that is safe, affordable, and convenient. This, very simply, is why the St. Luke’s family must continue to fight the good fight. Extended family members, the people of Idaho, are depending upon us.

 

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.