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After providing care for our patients for over 30 years at Spang Crest, my group was abruptly notified that we will no longer be able to provide medical care for our patients there. This privately-owned and operated facility has chosen to align itself with the large competing health systems (WellSpan, UPMC and Hershey) and have hospital-based physicians be the sole choice for their residents rather than allowing them to choose their own physician to provide their care. While hospital physicians are skilled in acute care, they often do not have the necessary experience to provide long-term, chronic care.

It saddens me that Spang Crest and Luthercare, which have been a proponent of compassionate and lifelong care, have chosen to allow the competing health systems in the area to come between their residents and their choice of physician. We have been told that this is strictly a business decision based on the changing payor environment. However, it is difficult to imagine that private physicians are the source of increased costs to our health care system. Multiple studies have shown that independent physicians provide care at a reduced cost for the same outcomes.

Our nursing home patients are some of our most vulnerable patients and many do not have anyone to speak for them, other than their physician with whom they have had a longstanding relationship.

Those of us still providing nursing home care, do so because we care about our patients, value our longstanding relationship with them and feel that they still deserve the same quality and personal care they have been receiving as an outpatient for many years. These patients have already given up so much—their independence, their homes, and now their physician.

This short notice and lack of discussion is unfortunately a common theme with large health systems where the individual patient and physician are not valued as a cornerstone of good medical care. It is concerning that the focus on “population health” has forgotten that the individual and the relationship he/she has with their physician is the basis of good medical care. No two patients are exactly the same and do not fall easily into “pathways of care.”

If you or a loved one is a resident of Spang Crest or one of the other local privately owned nursing facilities, I would urge you to contact the facility manager to express your opinion in regards to patient choice of physician. The state also has a Long-Term Care Ombudsman that can help facilitate your concerns.

All of us should have significant concerns about the direction health care is heading. There is no longer competition between health systems, hospitals and insurance providers—they are now one and the same. The insurance companies are the ones dictating what type of care and what level of care you can obtain, whether or not it is felt to be appropriate by your physician. It saddens me that as we proceed further along in this direction of consolidated health care, there will be no one left to advocate for the patient.

Anne Hayes, MD is a physician employed by Lebanon Internal Medicine Associates.

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