A rural hospital is losing a fight with a doctor

A rural hospital is fighting with a doctor . . . and losing

“The only hospital in Nashville is teetering on bankruptcy largely because, some say, it picked a fight with the wrong man: a popular local doctor, who now is referring his patients to hospitals in St. Louis and elsewhere.

Like many small-town hospitals, Washington County Hospital scrapes for every dime, and the grudge match with Dr. Thomas Coy has drained it of both revenue and credibility, officials say.

They say the drop in patients from Coy has contributed to financial shortfalls that could ultimately shutter the hospital, forcing Nashville’s 3,200 residents to travel 20 miles or more for even basic medical care.”

Comments

Intern in the District
What exactly is this guy getting paid to do if he isn’t doing surgery anymore?
Elliott
This article is a catalog of evils of how our current system works. A questionable doctor, lack of standards (the controversy about obstetrics), a , likely, unnecessary hospital, lack of transparency, uninformed consumer patients. I’m curious about why the reporter thought it important that Coy is a huge Republican supporter. Is he claiming Democrats at the hospital were out to get him?
Rich, MD
Elliott –
Those are pretty broad indictments, which I did not glean from the article.
Why is the doctor questionable? The hospital representatives raised questions about what are perhaps administrative issues, but not about his ability as a physician:
Hospital officials last week declined to specify the allegations but confirmed that they didn’t involve injuries to patients.
How do you get from there to a “questionable” physician? It is widely known (or widely alleged) that hospitals have used disciplnary proceedings to “punish” physicians who are vocal about hospital inadequacies. (See http://www.semmelweis.org)
As for the difference in opinion regarding obstetrics, perhaps Dr. Coy lacks faith in the available obstetrician. Perhaps there is disagreement about some issues that are not subject to standards, or where judgement is an issue. There really is not enough information in the article to draw any conclusions about these points. All we have is the quote:
He confirmed, for example, that he has never referred a single patient to the local hospital for obstetrics, citing a difference in “technique” between him and the hospital’s obstetrician.
So apparently Dr. Coy, if he is to be believed, has an opinion about some procedure or technique that the hospital obstetrican or someone disagrees with. He appears to be acting in what he believes to be the best interest of his patients.
And why do you think the hospital is unnecessary? What evidence is there for that assertion?
Elliott
Nothing proves any of my assertions, that’s just how I read the article combined with my own knowledge and experience:
Questionable doctor:
1. He’s not board certified.
2. He’s 68 years old.
3. The excuse of “paperwork” errors is used over and over again.
4. I don’t see the motivation for the hospital to cut it’s own throat unless there were serious problems. Just because everyone agrees that no patients were injured means little since dangerous practices don’t inevitably result in injury and the hospital might be hedging to cut its exposure. Also, the lawsuit was settled so we don’t know the terms.
Lack of standards:
1. If there was a difference in technique that was dangerous then why has the Ob not been reported by Dr. Coy?
2. Why is it a matter of opinion? With standards, you could point to something specific. This way, Coy gets to be coy about why he doesn’t refer.
Unnecessary hospital:
1. Losing money.
2. Small.
3. Other hospitals 20 minutes away.
4. Rural. I’m on record as suggesting that a better investment in healthcare dollars would be emergency medical evacuation rather than rural hospitals. I admit I’m, biased against small, rural hospitals.
Lack of transparency:
1. Noone knows why Coy was referred to the hospital’s credential review committee. Noone will ever know.
2. The doctors who have a problem with Coy are not allowed to speak.
3. Why is he still on staff if he won’t do the job he’s contracted to do?
Uninformed consumer patients:
Not a single reference to the actual quality of care or outcomes, just impressionistic anecdotes of how wonderful Coy is.
Rich, MD
My comments are really directed toward your presumption of misconduct on the part of the physician. There was an allegation, but in spite of a lack of evidence, you invariably conclude he/she must have done something wrong.
In medicine, there is not always one right answer or one right course of action. There may be many, and just because two Drs. disagree, it doesn’t mean that one of them is incompetent. But you presume it must be so, or one would have reported the other.
Curious JD
I thought if two doctors disagreed, it was because one was a hired whore for the plaintiffs.
Elliott
Rich,
I don’t have any specific evidence of wrongdoing. I used the word questionable specifically to reflect my feeling that there is the possibility, not certainty. If you read other articles, you will see that allegations of incompetence come from other staff members and that Dr. Coy is refusing to participate in an independent, 3rd party review. Again, that’s not proof, but it raises questions – hence, questionable.
Rich, MD
Fair enough Elliott – your point is well made.
CJD – I don’t believe I have ever held that opinion – I have said before that I believe that malpractice litigation has its place as do all of its players. Further, as much as I think there is a place for standards, there is always some degree of judgement, and never a single right “answer.” There are always multiple “correct” actions, and many more incorrect ones. But two doctors can disagree one which “correct” action is best.
asd
I’m not an obstetrician so this is speculation but I’d bet money that Dr. Coy thinks the obstetrician does too many C-sections without indication. I don’t think it’s unreasonable to steer patients away from a particular obstetrician if the guy’s C-section rate is in the 50-60% range.
Anonymous
I thought if two doctors disagreed, it was because one was a hired whore for the plaintiffs.
Oh, but of course.
However, do note that just because most docs hired by plaintiff attorneys are hired whores whose opinions are not worth the time of day, this does not mean that all docs with differing opinions are hired whores whose opinions are not worth the time of day.
It would appear, CJD, that to the list of your impressive failures of comprehension must be added some elementary stuff about classification. Venn diagrams may help.
Anonymous
Not only are you too frightened to even post with a pseudonym, you are incapable of recognizing sarcasm.
An impressive combination.
CJD
Anonymous
LOLOLOL.
1. Someone doesn’t seem to know when his puerile humor is being toyed with. Inability to recognize sarcasm, indeed.
2. Yeah, the reason people post using the “anonymous” option is not because that’s the easiest to do (one click), it’s because they are terrified that CJD will be able to come beat them up if they posted under “ABCD” or something.
Anonymous
Dr. Coy delivered my husband and my children. I do not believe for one second that this is do to him being a bad doctor. Some of his patients that were really sick asked to be transferred to bigger St. Louis hospitals. He did what he could do. He has been the main MD and Surgeon at WCH for almost 40 years. The new administator wanted to be in charge and trumped up charges so that she could be the big Kahuna. He has been a fabulous MD for our family and I don’t think you could find too many people there that have anything bad to say about him. Nancy Newby on the other hand?

A rural hospital is losing a fight with a doctor

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