PA, Doctor Have Problems with Mercy Plan

Valley City doctor Madeline Luke and Physician’s Assistant Russ Kaufmann have problems with a plan by Mercy Hospital to end use of physician’s assistants in the hospital and provide 24-hour, seven days a week emergency room coverage by a doctor through a contract with an out-of-state company.

Dr. Luke, who works as a doctor three days per week at the Sanford Clinic, said Tuesday, “I’m concerned we will have a variety of physicians come through with no local ties” once the contract takes effect.

On Feb. 5, Keith Heuser, administrator of Valley City’s Mercy Hospital, said the hospital was losing all its physician’s assistants at the same time it reached an arrangement so that a physician will be in the building at all times to ensure full care in the emergency room.

Heuser said that Mercy decided to contract with a specialty ER coverage service, Avera Health of Sioux Falls S.D. Heuser said the service will provide doctors trained in emergency services in the Mercy ER 24 hours a day, seven days a week, 365 days a year. This, in conjunction with the electronic/video system that links the Mercy ER with emergency room specialists in Avera Health, Sioux Falls S.D., will provide a more updated response in the ER.

Heuser said moving away from the model that allowed the hospital to use physician assistants was the most difficult part of the change. “These midlevel providers were a great asset to the hospital and very highly regarded health care providers in the community. Their commitment to this community and to exceptional healthcare services was invaluable. They were the core of our Emergency Room treatment team and we are extremely grateful for their service here.”

However, said Heuser, “In the long run it (the change) will be very positive for the medical staff.”

Heuser said the target date for getting the new arrangement into operation is May 1. Heuser said all Mercy physician assistants were told about the plans early, and all were offered other employment within the Catholic Health Initiatives system, the corporate parent of Mercy Hospital. Heuser said no Mercy physician’s assistants decided to accept the offer.

Russ Kaufmann, presently a full-time physician’s assistant at the hospital, said he was at the meeting when physician’s assistants were told they were being laid off. Kaufmann said he was not offered a job elsewhere in the CHI system, but Heuser mentioned there might be other jobs at hospitals owned by CHI open in North Dakota.

Kaufmann said he would not have accepted a job outside of Valley City even if one were offered. Kaufmann said one of the reasons for wanting to remain in Valley City is he and his wife have six children, “and we are settled in Valley City.”

Kauffmann said he has been a physician’s assistant for four years, coming to Valley City from a job in Fairbanks, Alaska, and grew up in Colorado.

Kaufmann said he could not understand why Mercy Hospital’s owner would decide to align itself with an out-of-state company, when the physician’s assistants and nurse practitioners now staffing the ER overnight and on weekends “are very dedicated to the community.”

Kaufmann said the target date for contracted emergency room services was first set on April 1, then was moved to May 1, and recently he heard June 1.

Heuser said that few people realize that Mercy hospital is a Level IV trauma center. This designation places greater responsibility on the facility to ensure that specific trauma treatment training of all the Emergency Room nurses takes place, that the ER is staffed by physicians and that specific response times in the ER are met. Until recently, the level IV physician requirements have been filled and met by the local medical staff.

“The residents of Barnes County and surrounding areas do not realize how fortunate they have been to have as committed a group of physicians as we have in Valley City. They have sacrificed their personal and family time to provide top notch care in our Emergency Room at no cost to the hospital or community,” Heuser said.

Heuser said things are changing partially in response to the demands of emergency room coverage on a smaller medical staff. He said the change will give the medical staff time away from worrying about ER coverage and to ensure that there is 100 percent coverage of the ER by a physician. The move is also a reflection of the responses received as part of Mercy’s patient satisfaction system. “Patients in the ER have expressed a desire to see the physician more quickly and to better understand the care they receive in our ER. This is a major step to meeting and exceeding those expectations.”