By Steve Huffman

Salisbury Post

Doctors from the Sanger Clinic will on Wednesday stop providing around-the-clock care for heart attack patients at Rowan Regional Medical Center.

The move is the latest development in a rift spurred by Rowan Regional's upcoming merger with Novant Health.

Sanger Clinic physicians are employed by Charlotte-based Carolinas Medical Center, which recently merged with NorthEast Medical Center in Concord.

Novant, Rowan Regional's merger partner, operates Presbyterian Hospital and serves as the other major hospital group competing with Carolinas Medical Center in the Charlotte region.

Carolinas Medical Center-NorthEast is currently seeking a state license to open a stand-alone emergency room in Kannapolis, while Rowan Regional/Novant is asking the state for approval to build a 50-bed, full-service hospital to serve Kannapolis and south Rowan.

According to Rowan Regional, Sanger Clinic officials told them last week that their doctors would halt their association with the hospital at the end of December.

Rowan Regional officials said three doctors associated with Mid Carolina Cardiology will continue providing cardiology services at the Salisbury medical center.

Still, they said they were greatly disappointed by Sanger's decision.

"We are obviously very distressed that the Sanger Clinic physicians want to discontinue their agreement with Rowan Regional and end providing emergency interventions to victims of heart attacks in Rowan County," said Chuck Elliott, Rowan Regional's chief executive officer.

Health-care officials said the move apparently stems from Rowan Regional's decision to merge with Novant Health and Presbyterian Hospital rather than Carolinas Health Care, parent company of Carolinas Medical Center. The merger becomes effective in January.

"We are disheartened that we have worked so hard to build our interventional cardiology program with the Sanger physicians and Carolinas Medical Center and that the residents of Rowan County will not have access to on-site emergency cardiac interventions, a service that does save lives," said Dr. David Smith, vice president of medical affairs for Rowan Regional.

Hospital officials said Sanger entered a contract agreement with Rowan Regional in February 2006. The contract, Rowan Regional maintains, was automatically renewed for two years in January 2007 and doesn't expire until December 2009.

Asked how the hospital is reacting to the Sanger Clinic's decision, Michael Burton, a spokesman for Rowan Regional, said, "We're exploring all available remedies."

According to statistics provided by Rowan Regional, Sanger doctors performed 18 interventional procedures at the Salisbury hospital in the past month. Twelve of those, Rowan Regional said, were emergencies.

But Sanger officials disputed much of what Rowan Regional said, including the number of patients their doctors have treated there.

According to Sanger, in September, their doctors did three emergency catheterizations and three elective ones in September, six emergency procedures and four elective in October and four emergency procedures and three elective in November.

Officials with Sanger said the decision to stop around-the-clock coverage at Rowan Regional was one of simple economics.

"As you can see," said Alan Taylor, a spokesman for Carolinas Health Care, "the emergency caths were averaging around one per week, not enough to sustain the program. It just doesn't make good business sense."

He said Rowan Regional officials wanted the emergency interventional catheterization program. Taylor said the hospital approached Sanger and Mid-Carolina Cardiology about providing the service.

Sanger agreed to help, while Mid-Carolina declined, Taylor said.

He said Carolinas Medical Center and Sanger invested heavily in the program at Rowan Regional, including the hiring of two doctors for the work.

"Investments that we will never recover," Taylor said of the money spent. "It is well known that certain volumes of patients are necessary to keep a catheterization program viable."

When Rowan Regional officials decided to merge with Novant rather than Carolinas Health Care, Sanger began seeing an immediate decline in referrals, Taylor said Monday.

Taylor said Sanger officials met with Elliott to discuss the decline, but the numbers continued to drop.

"As a result, the volume of patients is no longer appropriate to sustain the program, and we notified Rowan Regional that we would no longer provide 24/7 emergency care services," Taylor said.

Taylor disputed a news release from Rowan Regional that said Sanger intended to close its Salisbury office at the end of December.

In their letter to Rowan Regional, Taylor said Sanger Clinic officials announced they would no longer offer emergency heart catheterizations. Instead of saying they would close their Salisbury office at the end of the month, Sanger officials proposed ending services here at that time.

"But it is a proposal seeking a mutually agreeable date," Taylor said.

"It is unfortunate that Rowan Regional has issued a news release that fails to explain fully what is happening there," Taylor continued. "The physicians of the Sanger Clinic will look forward to treating patients from Rowan County as they did before the interventional catheterization program began at Rowan Regional."

In their press release, Rowan Regional officials said patients will continue receiving excellent care and promised that around-the-clock coverage for heart patients will be restored.

"We are working feverishly to try to resume 24/7 coverage for those patients who need this type of emergency cardiac intervention closer to home," Elliott said.

In the meantime, patients experiencing chest pains should call 911, and paramedics can help determine the best place to take patients for treatment, Elliott said. All emergency transport arrangements, including air ambulances, will remain available.

Rowan Regional officials said that all other services provided by the hospital's Smith Heart & Vascular Center are unaffected by Sanger's decision.

Doctors from Mid Carolina Cardiology will still perform diagnostic catheterization procedures at Rowan Regional to determine if blockages exist in a patient's coronary arteries.

Contact Steve Huffman at 704-797-4222 or shuffman@salisburypost.com.