In a battle that pitted two heavyweight Atlanta hospitals against a suburban one, the state on Friday sided with the underdog and granted Gwinnett Medical Center the right to perform open-heart surgery.
The decision came after a yearlong fight in which Emory and Piedmont hospitals tried to block approval for the Gwinnett hospital program — and nearly succeeded.
The decision by Dr. Rhonda Medows, the commissioner of the state Department of Community Health, reversed a state panel decision two months ago that turned down the Gwinnett request. That panel decision in May, in turn, had reversed prior approval by the DCH last year.
Medows’ decision in favor of the Gwinnett hospital was only made possible by a recent change in state law.
“This good news has been a long time coming,” said Phil Wolfe, the Gwinnett Medical Center’s CEO.
Officials at the Gwinnett hospital say the new $33 million program for open-heart surgery will save precious time for people who need the procedure, preventing death and disability to residents in Gwinnett.
The open-heart program — slated to open in 2011 and perform up to 500 surgeries a year — would be the first in Gwinnett, which hospital officials say is the largest county in the nation without its own open-heart program.
The center will eliminate the barrier of traveling congested roads to obtain such care in other counties, they said.
Officials from Emory and Piedmont hospitals, which perform open-heart procedures, responded to Friday’s decision by saying Gwinnett residents already have adequate access to such procedures at numerous metro Atlanta hospitals.
Emory spokeswoman Sarah Goodwin said in a statement that the Gwinnett decision will create an “unnecessary duplication of services.”
Piedmont officials said the extra service will cut into the number of surgeries that metro Atlanta surgeons need to perform to stay sharp, and it “would be detrimental to existing quality programs and all Georgia residents.”
Medows’ ruling, which represents the final administrative decision on the issue, surprised some medical experts.
“You would think with Piedmont and Emory’s reputation and political clout ... they would prevail,” said Michael Rovinsky of Integrity Consulting Group, a health care consultant for some 25 years.
The battle of these hospitals has been heated. In Gwinnett, the proposal became a community effort, with proclamations of support from the County Commission, the chamber of commerce, elected officials and the school board.
State Sen. Don Balfour (R-Snellville) said the true goal for Emory and Piedmont was simply to stop the creation of more competition.
This month, some 50 Gwinnett hospital physicians, trained at Emory, published a letter in a local newspaper urging Piedmont and Emory to halt their opposition to the plan.
Gwinnett had to obtain state approval — called a Certificate of Need — to perform open-heart surgery under Georgia law. The law is intended to prevent the duplication of major services.
The law was amended last year to create an appeals panel and a final review by the commissioner of the Department of Community Health. Before that, appeals were handled by a nine-member review board appointed by the governor.
Balfour said the new process, which includes time limits on handling appeals, is aimed at speeding up a process that in the past could be held up in appeals for years.
Emory and Piedmont asserted that a new Gwinnett program would hamper Emory’s cardiovascular teaching programs by decreasing the number of surgeries available for teaching purposes.
Medows disagreed.
“The department reasonably concluded that traffic congestion and travel times present a barrier to a significant number of patients obtaining timely access to open heart surgery services,” the commissioner’s final decision said.
Medows also noted that fewer than 100 patients from Gwinnett annually receive open-heart surgery at Emory training sites, asserting that Gwinnett’s program “is unlikely to significantly impact Emory training site volumes.”
Some experts say the fight may not end here, that Emory and Piedmont may challenge the ruling in court.
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