Local kidney patients see hospital options dwindle

Pneumonia sent Kathy Samuel to the hospital in December, but not the hospital of her choice.

Providence Holy Family Hospital is within 3 miles of Samuel’s North Side home. But the 66-year-old former piano saleswoman – who is on dialysis for chronic kidney disease – was told she’d have to go downtown to Deaconess Hospital if she wanted to have to access to her kidney doctor while she was hospitalized.

Her doctor is part of Rockwood Clinic’s Kidney and Hypertension Center. Last fall, the center’s nine doctors dropped their privileges at Spokane’s two Providence-affiliated hospitals: Holy Family and Sacred Heart Medical Center. The doctors continue to see patients at Deaconess and at Valley Hospital, both of which are owned by Community Health Systems, the Tennessee company that purchased Rockwood Clinic in late 2009.

That’s created a quandary for Samuel, who is loyal to her Rockwood doctor but prefers to be admitted at Holy Family because it’s easier for family members, including her parents, to visit her when she’s hospitalized.

She and other Rockwood kidney patients say they feel like pawns in a power struggle between Spokane’s two competing hospital systems, which have been buying up clinics in recent years.

“This politics is driving me nuts,” Samuel said in a recent interview. “This isn’t what sick people need when they’re trying to get well.”

While she and other kidney patients suspect that Rockwood’s affiliation with Deaconess and Valley hospitals influenced the doctors’ decision to drop privileges at Providence-owned hospitals, Rockwood officials said it was a workload-driven move.

Over the past year, local nephrologists – doctors who specialize in treating kidney disease – have been cutting back on the number of hospitals where they have privileges, said Queena Liufau, Rockwood’s spokeswoman.

Doctors at two different nephrology practices used to see patients at Deaconess and Valley hospitals, but that changed last year, leaving only Rockwood physicians to cover the kidney patients admitted to those two hospitals, Liufau said.

The doctors had to decide where to focus their efforts, she said. They were stretched too thin trying to oversee care for kidney patients at four Spokane hospitals, plus several clinics and Kootenai Health, a Coeur d’Alene hospital.

“As the only practice covering Deaconess and Valley, it was critical to maintain our privileges there to care for patients in need,” Liufau said in an email.

Carol Belton, a Rockwood kidney patient and retired nurse, remains upset by the change.

“My doctor knows that I prefer Sacred Heart,” she said. “I trust the staff and the hospital, and that trust level is big for me.”

Belton worked at all the local hospitals during her 46-year nursing career but spent most of her time at Sacred Heart, where she did a four-year stint as a dialysis nurse. The 73-year-old also has a high regard for her Rockwood nephrologist, with whom she has a four-year doctor-patient relationship.

When the Rockwood doctors had privileges at Sacred Heart, hospital care was seamless for her, Belton said. Now, if she’s admitted to Sacred Heart, another doctor will be writing her dialysis orders and overseeing any kidney-related care.

“Having somebody brand-new who doesn’t know you at all is a little frightening,” Belton said. “It puts the patient at a disadvantage.”

Sacred Heart also has Eastern Washington’s only kidney transplant program, which performs about 50 transplants each year. Both Belton and Samuel are on the waiting list there for a new kidney.

“I’ve already gone through two pre-transplant screenings,” Samuel said.

Rockwood patients can still get kidney transplants at Sacred Heart, Liufau said. The doctors work with the patients and their families to refer them to a transplant program, and nothing prevents them from being referred to Sacred Heart, she said.

Sacred Heart’s transplant program sees patients from Washington, Idaho, Oregon and Montana. Many of the doctors who refer patients to the hospital’s program don’t have privileges at Sacred Heart, said Dr. Jeff Collins, Providence’s chief medical officer.

“When it’s time for those patients to be referred for a transplant, we are happy to see them and evaluate them for treatment,” he said.

If the kidney transplant took place, the patient’s care after discharge would be coordinated with the individual’s regular nephrologist, he said.

Collins also echoed Rockwood’s remarks about fewer local doctors keeping privileges at all four Spokane hospitals. In the past, it was common for some doctors to see patients at multiple hospitals, he said. That’s changed over time because the patients who are hospitalized tend to be sicker.

“If you’re not that sick, you’re not in the hospital anymore,” Collins said. The patients who are hospitalized have more complicated health issues, with multiple things going on. “It’s more complicated, it takes more time. And it’s why many physicians have reduced the number of hospitals where they have privileges,” he said.

Samuel, the kidney patient, is torn about how to proceed. Her extended family lives on Spokane’s North Side, and their visits mean the world to her when she’s hospitalized.

“It’s easier for my husband to visit me at Holy Family,” she said. “My kids, my brother and my parents live on the North Side. My parents are in their 80s, and they don’t like to drive downtown during the winter.”

But she likes her Rockwood doctor, too. “He knows his stuff,” she said. “When there’s a problem, he’s right on top of it.”