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Thursday, December 7, 2023


Jan. 1, 2004 – A group of doctors has filed an application with the Health Department, seeking permission to set up a private outpatient surgery center on St. Thomas. It's a development that is causing concern for some top officials at the Roy L. Schneider Hospital, who say the creation of a so-called "boutique hospital" will bring unfair competition.
A campaign of newspaper ads and radio talk show appearances by Schneider Hospital CEO Rodney E. Miller Sr. has sparked a public debate on the issue. Among those voicing opinions is a St. Croix lawmaker who says the appearance of a private surgery center in the Virgin Islands is part of a national trend and government officials should learn more about how new health care alternatives will impact public health care policies.
Acting Health Commissioner Darlene Carty said the application for a Certificate of Need was filed for an ambulatory surgical care center Dec. 11. "It was a revised submission, from a prior submission that was filed by this particular group … It has been forwarded to our legal counsel and the Department of Health has initiated the review process of this application," Carty said on Wednesday.
The commissioner said a decision on the application could come in the next 60 days and will be made collectively with the help of the legal counsel and his staff who are now reviewing manuals that point out different considerations that should be taken into account.
As he laid out his case against what he called "boutique hospitals," Miller expressed concern about what he called secrecy surrounding the application process. Miller also alluded to a sense of betrayal, saying that some of the doctors now employed at Schneider Hospital are part of the group that wants to build an outpatient surgical care center next to the hospital.
"The select few physicians who go into these things go into it to make money. [They] capitalize on the most profitable outpatient surgeries and leave the hospital with the more complex, major surgeries that are the less profitable services, which is a direct conflict of interest and one that would cripple our hospital," he said.
But David Bornn, the attorney representing the medical group, refuted Miller's claims that a for-profit private health care center would lure away scarce medical and technical staff and leave Schneider Hospital less equipped to perform surgery on needy patients without the resources to pay their medical bills.
"The assertion that these doctors would be pulling the cream of the crop — so to speak — of the revenue of the hospital is incorrect," Bornn said. Within the group of applicants are some doctors who have worked at the hospital and some who have not, he said, and some who intend to continue performing outpatient surgical procedures at Schneider Hospital.
The types of outpatient procedures expected to be performed at the center represent about 12 percent of the surgeries now done at Schneider Hospital, Bornn said. Miller said he is worried that the patients undergoing those procedures will be some of the better insured and most able to pay and that, if their business goes into a private practice, it will hamper efforts to turn around the hospital's financial problems.
Sen. Usie Richards also weighed in on the debate, saying if there is a problem with the scenario now being played out before the Health Department, it is not a legal problem.
"I don't think we have a problem with the law," Richards said. "What I think we may have a problem with is the Department of Health, as a regulatory agency, not having sufficient manpower or know-how to properly review the Certificate of Need application and to determine its impact on the health system and the health status of the Virgin Islands before the issuance of a Certificate of Need for a particular applicant."
But the St. Croix senator pointed out that the application process is not secret, as some have claimed. He said that he is looking forward to seeing how the application process plays out and how the new facility, if established, impacts the availability of services to other Virgin Islanders who either don't or can't afford to obtain services there.
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