Some Silver Valley residents are angry that a Wallace doctor is being evicted from his practice for refusing to send patients to a local hospital - even though he says there’s no reason to send them there.
The East Shoshone Hospital District owns the building Joseph Miller leases, and justifies his eviction because its cash-starved Silver Valley Medical Center needs more patients.
Miller’s supporters say he’s just doing what a decent doctor should - refuse to waste patients’ time and money on frivolous hospital stays.
“They act like there’s supposed to be a quota,” activist Brenda Auld said. “The doctor only admits patients who need admitting, and then only to the hospital that is best equipped.”
Miller - a popular doctor with more than 1,000 patients - has until July 18 to clear out of the Wallace Medical Clinic.
In response to questions, hospital district chief executive David Hughes faxed a list of four doctors who work on the hospital staff or lease district space, and how much money each made for the district this year. Miller brought in $1,831; most of that for outpatient visits from home health-care nurses - leaving just $204 for the hospital.
William Dire, the doctor who shares the clinic with Miller, made $313. Dire is retiring this summer.
“The hospital board and that whole system is very threatening and very out of control,” said Dire, who has practiced since 1965.
Both doctors run their own, private practices.
With them gone, “the trustees will take this opportunity to place someone in the Wallace Medical Clinic who will participate in helping Silver Valley Medical Center to survive financially and fulfill its mission to the people,” Hughes’ fax said. He did not return phone calls for further comment.
The top-admitting doctor brought in more than $1 million for the hospital district.
Protesters are incensed that the eviction came down to dollars.
“Dr. Miller will not break the law by mandatorily admitting people,” Auld said. Miller said he wonders if the demand for patients is even legal, or how insurance companies would react.
Unnecessary hospital stays billed to insurance companies cause rates to climb - meaning everyone with a policy pays.
And since some patients’ healthcare is government-funded, unnecessary stays cost taxpayer dollars. Two years ago, President Clinton announced a crack-down on Medicare and Medicaid fraud and waste. At the time, 10 percent of the Medicaid and Medicare budgets in both programs’ five biggest states was spent on fraud and abuse - $1.5 billion.
Idaho State Attorney General spokesman Bob Cooper said the Silver Valley hospital’s plea for patients doesn’t sound illegal in itself. If someone is admitted fraudulently expressly to bilk insurance companies, then it’s illegal - carrying a 15-year jail sentence, a $15,000 fine, or both.
Otherwise,”Sometimes, even greed isn’t illegal,” said Idaho Insurance Commissioner James Alcorn.
Miller said the district gave him 45 days to get out of its building shortly after he offered to buy it. He said it hasn’t been painted since 1988, and that one of the windows is shattered. If he owned the building, he could fix those problems himself.
Miller said he was told the hospital wanted him to use its lab and X-ray equipment. He currently rents one of the district’s X-ray machines; he said he sends lab work to Spokane because it’s less expensive.
Hospitalizing people is a last resort, Miller said, adding that many prefer outpatient care instead.
And “of the people I’ve hospitalized … they’re people who needed more than either of these hospitals could have provided,” he said of the hospitals in Silverton and Kellogg.
Miller said he was on the Silver Valley Medical Center’s active staff until 1995.
When he failed to hospitalize a dozen patients a year, he was bumped down to courtesy staff, Miller said.
“I’ll never do that,” he said. “That’s just abuse of the system. The hospital makes money, you make money.”
Being on courtesy staff meant Miller couldn’t vote on medical staff issues, but he also didn’t have to be on emergency room call.
“Now they’re saying I’m not supportive of the hospital because I don’t work emergency room call,” Miller complained.
Courtesy staff members are supposed to be able to treat their own patients if they are hospitalized, Miller said. He claims patients who asked for him were told he wasn’t on staff at all.
Earlier this year, Dire received a letter from the hospital district saying that the district was scouting around for a more lucrative doctor to take his space.
The letter said the board wanted to lease space to a doctor who “strongly supported” the hospital. “It was the board’s hope that you would be that physician,” it read.
Now that Dire is retiring, it wouldn’t matter - except his patients were to start seeing Miller instead.
As a result, patients like Jan Kelly are frustrated that Miller won’t be their doctor. “I’m one of his champions,” she said.
Her motto: “Hell no, we won’t let him go.”
The windows of her Double D Trading Post antique and consignment shop are plastered with notices. She, Auld and others have also placed hundreds of them beneath windshield wipers and inside restaurants and bars. Auld, a local activist, is recruiting pickets for the hospital board’s next meeting.
The notices read: “If you don’t want to be part of East Shoshone Hospital District’s … plans to evict, destroy and take away a career and patients from Dr. Miller … please attend the Silverton Hospital Board meeting.”
A time for the next meeting has yet to be set, but Kelly said her telephone has been “ringing off the hook.”
“He’s one of the best,” Kelly said. “I’ve seen several doctors, and he’s the only one who has sat down and talked to me … he does that to every one of us.
“He knows you when he sees you on the street. He doesn’t need the medical chart to know you.”
Miller said he was shocked by the rippling reaction. “That’s really something. I was really surprised and pleased at the support I’ve had.”
, DataTimes MEMO: Cut in the Spokane edition
Subscribe to the Coronavirus newsletter
Get the day’s latest Coronavirus news delivered to your inbox by subscribing to our newsletter.