June 18, 2009 in City

Deaconess closing Parkinson’s clinic

Movement-disorder patients lament loss

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Patients with Parkinson’s disease and other movement disorders are frustrated by a decision by the new owners of Deaconess Medical Center to close a clinic and dismiss its director, Dr. Anthony Santiago.

The Movement Disorder Clinic will close Aug. 5, Deaconess informed patients in a letter. Patients and their families were encouraged to find other neurologists from a list of four other medical groups in Spokane, or the Booth Gardner Parkinson’s Center near Seattle.

Deaconess officials said the closure is a cost-cutting measure necessary to maintain adequate funding for the hospital’s core services. Santiago will no longer be paid by Deaconess but will keep his hospital privileges.

Hospital spokeswoman Christine Varela noted that Deaconess will lose $10 million in Medicaid funding over the next two years.

“I think you’ll see hospitals across the state being extremely judicious where they use their resources,” she said.

Community Health Systems Inc. bought Deaconess, along with Valley Hospital and Medical Center, last September. In the months since, the hospital company has purchased new patient beds, upgraded technology and recruited new physicians. At the same time, the hospital has cut trauma care services at the hospital, struggled to bargain a new contract with union workers and closed the movement disorder clinic.

Santiago, a movement disorder specialist who left Rockwood Clinic several years ago, has built a loyal following, with a patient base of more than 800.

Many of Santiago’s patients are on Medicare, and patients say this makes the clinic a prime target for hospital budget-cutters.

Sue Green, whose mother is a patient at the clinic, said Santiago spent extra time with patients, which she said probably put him at odds with financial expectations.

Jeanette Ritner credited Santiago with providing her husband, Robert, expert care that included careful management of his prescriptions – key to living with Parkinson’s disease.

“My husband has been rejuvenated, and today he is active and enjoying life as opposed to not being able to do anything,” she said.

Bill Bell, executive director of the Northwest Parkinson’s Foundation, said the loss of Santiago’s practice will be a regional setback. Patients travel to see him from Montana, Idaho and across Eastern Washington.

“At what point do you put community care ahead of the bottom line?” Bell asked. “This decision is a tragedy for patients. What Spokane is losing is a doctor who is truly empathetic, knowledgeable and caring.”

There’s a disconnect, he said, between a patient’s desire for ample time to speak with a doctor and the financial reality of modern clinics, where a patient may see a doctor for mere minutes.

“Here we have a doctor who would take the time to understand a patient,” Bell said. “Even if a patient comes in and there’s not much that can be done, at the very least you can sit with them and hold their hand and listen.”

Santiago and his staff at the clinic in Liberty Lake were told not to speak with the press regarding the closure.

Bob Dunn, an attorney who represents Santiago in employment contract matters, said the doctor is trying to sort out his future after the surprise decision by Deaconess.

“(Dr. Santiago) regrets and has sadness that Community Health Systems has chosen to close the practice,” Dunn said, adding that his client hopes the region can support the needs of patients with neurodegenerative disorders.

The clinic served patients with disorders including dystonia, Parkinson’s, Tourette’s syndrome and essential tremor.

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Three comments on this story so far. Add yours!

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  Kathleen McClelland on June 18 at 10:58 a.m.

  The closure of the Movement Disorder Clinic in Liberty Lake is a tremendous loss to this community, and I am saddened and disheartened that Deaconess has made this unfortunate decision. Dr. Santiago was key in my recovery over the last 1 1/2 years. I truly believe that I would be in a wheelchair today if he had not taken over my care. He is an exceptional caregiver with a superior staff that you could always count on to be empathetic, compassionate and available. Something that is almost unheard of in this medical community. Thank you Brenda, Melinda and Bonnie!

  It seems the bottom line at Deaconess has become more important than patient care. By closing the clinic they have taken my right to “choose my own Dr.” away and it makes me angry. The time, care and comfort Dr. Santiago gave to each one of his patients was beyond anything else available in this area. Now we must find a different neurologist at our own expense and this means financial as well as emotional. Deaconess tells us that to transfer our records we must pay them 67-88 cents per page. With an 800 patient base practice with most of those patients having charts the size of a phone book (or two) this could end up costing each patient hundreds of dollars! I am certain that sounds reasonable to their Board of Directors.

  Dr. Santiago has remained completely silent through all of this and it appears there could be legal repercussions if he doesn't. He hasn't even been allowed to write his patients a letter saying good-bye. My husband and I spent many hours with him discussing my health and course of care and I want to personally thank him for that. It is only because of him that I can live a normal life today. I cannot just walk away and pretend he had no part in my recovery. The loss of my Dr. is like a death in my family and I need to have closure.

  While I understand that during these critical economic times some sacrifices must be made, I believe this was handled very poorly. I am embarassed that this is how a health care facility as large as Deaconess and Community Health Care Systems thanks one of it's own.

  Kathy McClelland

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  slwoodbridge on June 29 at 1:54 p.m.

  Kathleen's comment in regards to the dismissal of Dr. Santiago, his staff and his practice speaks volumes for those who were under the care of this exceptional physician. She hit the nail right on the head. Dr. Santiago took great care with each of his patients, treating each as if they mattered. He didn't merely treat them as a patient, but as a friend. Under his care for over five years, his office was run professionally, yet with compassion and a personable attitude by him and his great staff.

  Thanks Kathleen for the excellent comment which speaks for all of us who were blessed to have Dr. Santiago for our doctor. He will not be able to be replaced.

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  j70155 on September 06 at 12:23 p.m.

  A very poor, yet not surprising, decision by Community Health. Remember what their mission is - create value ($) for their stockholders, PERIOD.

  Any component of Deaconess or Valley not measuring up in terms of appropriate EBDITA (Earnings Before Depreciation, Interest, Taxes, Amortization) is subject to elimination, regardless of the negative impact on the healthcare needs of the community.

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