Deal with Atlanta corporation draws attention to PeaceHealth remarks at 2024 forum

Presenter: There is new scrutiny this week of Dr. Jim McGovern’s remarks at a Sept. 26, 2024 citywide health care forum. Before hundreds attending at Willamette Christian Church and more watching online, the chief hospital executive of PeaceHealth expressed concern for Eugene’s independent physician practices. Dr. Jim McGovern:

Dr. Jim McGovern: So I want to talk a little bit about practices and them being acquired. There are very few cardiology practices left that are independent, primarily because the reimbursement has changed and they can’t make it and support the clinic and support their salaries. 

I have probably four conversations a month—at least—with groups in town, around: ‘How can the hospital support them so they can stay independent?’ or ‘How can we purchase their practice because they’re failing,’ or ‘They’re getting ready for retirement and they can’t recruit physicians in.’ 

So there are certainly entities out there that are gobbling up practice and there’s probably a profit margin driving it. 

I will say here in Eugene it is about the survival of our independent practices. It is about maintaining the delivery of surgery, of anesthesia, of any number of different practices that we support through the hospital. So it does take all of us.

Presenter: At that 2024 forum, he also said PeaceHealth was seeking to lower wait times in the Emergency Department. Dr. Jim McGovern:

Dr. Jim McGovern: So we have work to do. We have opportunities and looking at a couple of our ER docs over there who remind me daily about our waits in the Emergency Department lobby, something we are working hard to decrease.

So we are not perfect. There’s plenty of gaps that we have. But we do deliver high-quality and high-end health care to the communities that we serve, and we intend to continue to do that for the next seven decades.

Presenter: Less than a year and a half after Dr. McGovern expressed concern for independent practices, local leaders are scrambling to support Eugene Emergency Physicians, after PeaceHealth picked an Atlanta corporation to provide ED services.

KEPW 97.3 Whole Community News livestreamed the forum in 2024. Here are all of Dr. McGovern’s statements in context, as he offered opening and closing remarks, and also responded to questions about a Eugene teaching hospital and about the patient-doctor radio.

Dr. Jim McGovern: I’m Jim McGovern. I’m the chief hospital executive for PeaceHealth in the Oregon network. So I have responsibility for RiverBend, Cottage Grove, and PeaceHarbor in Florence.

I’m an internal medicine hospitalist by background. I’ve been in this community for about five and a half years, so May of 2019. I also live in the neighborhood. 

So: Why am I here? We’re one of the main suppliers or—sorry. I’m not used to big crowds. Anyways, we provide health care to a large portion of the community and you’re our customers.

So being here to listen, to have conversation, to just kind of understand the experiences is important to me, important to PeaceHealth, and I’m looking forward to the evening.

Presenter: Questions from the community were presented by the evening’s moderator, Jensina Hawkins. 

Jensina Hawkins (Citywide Health Care Forum, moderator): We have heard and read that Lane County doctors and group practices have as many as 2,800 patients under their care. What are you doing to decrease the number to a manageable size to ensure more time with each patient and to decrease waiting times for an appointment?

Dr. Jim McGovern: From a PeaceHealth perspective—and I’m more hospital than outpatient—but we have hired a number of nurse practitioners to help manage the in-basket or the inbox of the physicians. So that allows us to add a little bit more capacity to them.

We are hiring new primary care physicians. That’s a short-term fix. We’ve opened up the Pleasant Hill Clinic as well, and we’ve moved out of the West 11th Clinic prematurely to open the Hilyard Urgent Care, knowing that the county was coming in behind us. 

But I’ll just echo what (Optum’s Dr.) Phil (Capp) said. We cannot continue to deliver primary care the way we have traditionally. We just don’t have the physicians, and so we have to find a different delivery model that creates more access, that delivers the same quality of care that has the physicians in the places where they’ve been trained to be, and has other caregivers where they are adequate, have the knowledge, and can provide the care that they can provide. 

So just the way that the population is growing, the dearth of new physicians coming out—personally, I don’t see the traditional model of primary care being sustainable into the future.

Presenter: The moderator took a question from the audience, then repeated it for the benefit of those who couldn’t hear. Jensina Hawkins:

Jensina Hawkins: That’s a great question. Can we get a medical school here? 

Dr. Jim McGovern: Let me backtrack and I will get to that if that’s okay. 

So I do want to reiterate, the system is broken. You feel it on the receiving end. Our physicians work in it, we try to manage in it. I mean, I’ve been a clinical physician, it’s been a little over a decade, and we all know that it’s broken. We can do a little bit at the state level. It is ultimately going to get fixed at the federal level. 

So I want to talk a little bit about practices and them being acquired. There are very few cardiology practices left that are independent, primarily because the reimbursement has changed and they can’t make it and support the clinic and support their salaries. 

I have probably four conversations a month—at least—with groups in town, around: ‘How can the hospital support them so they can stay independent?’ or ‘How can we purchase their practice because they’re failing,’ or ‘They’re getting ready for retirement and they can’t recruit physicians in.’ 

So there are certainly entities out there that are gobbling up practice and there’s probably a profit margin driving it. 

I will say here in Eugene it is about the survival of our independent practices. It is about maintaining the delivery of surgery, of anesthesia, of any number of different practices that we support through the hospital. So it does take all of us.

I’m thrilled that McKenzie is opening an emergency department. It frees up our capital to open an inpatient rehab facility. That’ll double our beds, it’ll bring a traumatic brain injury to Eugene, something that doesn’t exist in the Northwest. You have to leave the region to get that.

It allows us to work with the county on crisis stabilization and look at what behavioral health needs going forward.

We are actually in the process of looking at a primary care residency. If we started it, the process today full-bore, the first resident would come out five years from now. So, but the time to plant the tree is now.

So we are looking at a residency program, anesthesia, those types of residency programs, psychiatry, are possibilities, but you have to start with primary care. So a decade from now is a long time, but it’ll come fast. We may have multiple residency programs in town.

Medical school is an incredibly ambitious thing that I don’t see PeaceHealth taking on. but through other coalitions and other leadership in the community, we’d welcome being part of it… 

Presenter: A member of the audience pressed for more. Dr. Jim McGovern continued:

Dr. Jim McGovern: A medical school would be fantastic. It is going to take the community across the board and is something that probably we can look at after we get a residency program up and going. 

But the other thing to that is, physicians are hard to find. We also have to look at CRNAs (Certified Registered Nurse Anesthetists). We have to look at nurse practitioners. We have to look at our other health clinicians who can in the right place expand our access to care and deliver the things that we need to do.

If we hold onto a purely MD model, we will not be able to care for the individuals in this room the way that they need to be cared for and deserve to be cared for.

Presenter: Offering his closing remarks at the citywide health care forum on Sept. 26, 2024, PeaceHealth Chief Medical Executive Dr. Jim McGovern. 

Dr. Jim McGovern: PeaceHealth has been here for a very long time before I got here. We’ll be here for hopefully a very long time after I get here.

We did close University District Hospital. We’ve talked about that a little bit. It was about a $24 million loss annually and we only have so much money to invest, so what we save from the University District goes back into the community.

We’re breaking ground on the inpatient rehab facility next month. If you have a stroke, if you have a car accident, you have a traumatic brain injury, we’ve increased the capacity to have your care delivered locally.

We’re able to partner with the county on the crisis stabilization center. We’re able to look forward to more investments in behavioral health, which this community desperately needs. We are opening 70 more beds at River Bend in the next two years, a couple more ORs, so we are expanding access in the hospital.

I will say as a hospitalist and a hospital administrator, I do not want to see you at RiverBend. That’s not where you belong. If you can get your care in the community and we can keep you healthy and out of the hospital, I am all for that. 

So the other thing, there was a comment made about being in backwoods health care, which I took a little bit personally. So I just want to talk a little bit about what RiverBend delivers.

The University District wasn’t Eugene’s hospital, it was the community’s hospital. RiverBend is not Springfield’s hospital, it is the hospital of the broader community. We have the only comprehensive stroke center north of Sacramento and south of Portland. If you have a stroke, there’s a pretty good chance we can pull that clot out or dissolve it.

We are doing minimally invasive cardiac surgery. So the old way where we open up the sternum and you’re in the hospital for five or six days with significant pain, we now go through or have the ability to go through an inch or two on the side. You’re in the hospital for three days, much less discomfort.

We’re doing robotic valve replacements. We were the first in the state to get the most advanced robot. That’s number four. We’re looking at number five. 

So we have work to do. We have opportunities and looking at a couple of our ER docs over there who remind me daily about our wait in the emergency department lobby. Something we are working hard to decrease.

So we are not perfect. There’s plenty of gaps that we have but we do deliver high-quality and high-end health care to the communities that we serve, and we intend to continue to do that for the next seven decades.

So I appreciate being here tonight and with all my friends, so with that I’ll end.

Presenter: Eighteen months after its chief medical executive expressed concern for local physician practices, PeaceHealth chose a corporation in Atlanta, Georgia, to serve its Lane County emergency departments. 

That has left 41 clinicians with Eugene Emergency Physicians looking for answers. In a statement, PeaceHealth said:

‘As part of PeaceHealth’s commitment to delivering the highest quality care in our communities, in November we issued a Request For Proposals for emergency department physician services for Sacred Heart Medical Center at RiverBend, Cottage Grove Community Medical Center and Peace Harbor Medical Center.

‘After a comprehensive assessment led by Oregon-based clinical and administrative leaders, we selected ApolloMD as our emergency medicine partner at our three Oregon emergency departments.

‘This new partnership will begin in the summer of 2026. During this transition, we remain steadfast in our commitment to uninterrupted, high-quality emergency care for Lane County.

‘ApolloMD is a physician-owned, clinician-led organization. Both PeaceHealth and ApolloMD understand the importance of clinicians who live in and understand the communities they serve.

‘This change is part of our investment in our emergency departments, which will also include a renovation of the RiverBend emergency department that will expand access and further reduce wait times.

‘In addition to collaborating on the ED remodel, PeaceHealth clinical and administrative leaders have been meeting weekly with Eugene Emergency Physician leaders to focus on process improvement in the RiverBend emergency department.

‘PeaceHealth appreciates the care EEP clinicians have provided patients at RiverBend and Cottage Grove. While contract discussions are between individual physicians and ApolloMD, we sincerely hope these physicians choose to remain in the community and continue to work with us.’

Beyond the statement, we asked Dr. McGovern to explain why PeaceHealth was not sustaining a local independent physicians practice, but instead replacing it. He has not yet responded, but he may have answered the question 18 months ago. During the first citywide health care forum, Dr. Jim McGovern: 

Dr. Jim McGovern: So there are certainly entities out there that are gobbling up practice and there’s probably a profit margin driving it.