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Physician Compares Ambulatory and Cancer Centers

Dec. 29, 2004 – Dr. Bert Petersen, a native Virgin Islander, nationally known cancer specialist and one of the driving forces behind the Charlotte Kimelman Cancer Center, asked Rotary Club II members Wednesday if two separate entities — one in progress and the other on the planning board – would meet the Rotary Club's four tenets.
Petersen is the lead medical planner for the Cancer Center – dubbed its "physician champion." The other facility he discussed is the proposed ambulatory surgical center.
Petersen, who is spending Christmas at home, vacationing from New Jersey where he is a cancer specialist at Hackensack University Medical Center, said, "What's been on my mind is, 'Am I my brother's keeper' — and that's what I'll talk about."
He talked about the discrepancy in the treatment of African-Americans in the medical world. He described a program that is under way to eliminate discrimination by 2010. "Eliminate," he stressed. He said African-Americans have higher cancer, hypertension and diabetes rates than Caucasians, and treatment for these conditions is not fair. It's going to be an uphill battle, he indicates.
He told the Rotarians that they must get involved in helping the island's almost 90 percent African-American population in getting adequate medical treatment.
Reminding the Rotarians they are "their brother's keepers," he brought out the four Rotary tenets: "Is it the truth? Is it fair to all concerned? Will it build goodwill and better friendships? Is it beneficial to all concerned?"
He gave the Cancer Center a resounding "yes," to all the requirements. He gave the proposed ambulatory surgical center a resounding "no."
Petersen said the cancer center, which will "serve the Caribbean diaspora, all the regions" is the first of its kind.
Petersen explained that the center will treat everything – "the mental aspect of treatment as well as the physical." He explained that a staff will be there to handle patient needs, from insurance matters to a schedule of radiation.
He said, in contrast, in Puerto Rico, "You go to one doctor for diagnosis, another for radiation or chemotherapy, and another for surgery."
Petersen shared some chilling medical facts. Cancer is the second leading cause of deaths in the Virgin Islands, and the percentage has been steadily increasing. One-fifth of the territory's deaths are due to cancer. By 2007, one in 200 residents will be diagnosed with cancer.
Petersen said there's a need for comprehensive services to patients, help with ancillary services and particularly for patient follow-through.
The ambulatory surgical center, Petersen said, will not benefit the community. He said it will drain revenues from the hospital and would "devastate services to the poor and under insured." The Roy L. Schneider Hospital is a "safety-net" hospital; it must accept anyone who comes to its doors, unlike private ambulatory surgical centers that can cherry-pick their own patients, he said.
"The hospital provided about $15 million a year in uncompensated care," Petersen said, "which accounts for about 33 percent of the hospital's gross revenue."
Earlier this month, Health Commissioner Darlene Carty approved a Certificate of Need for the facility, despite no financial feasibility study or economic analysis of the proposed facility.(See "Carty Approves Ambulatory Surgical Center").
Petersen pointed out that no other health care system in the country of the size of St. Thomas allows its own physicians who receive stipends for certain services to open their own competing facilities right across the street.
"That serves as a conflict of interest," he said, "to compete with the very hospital and government that is paying them to deliver care to the people of the Virgin Islands. I want to make it clear that this ambulatory center is not going to bring in new services to the V. I.. In fact, they would offer the same services the hospital now provides. Is that fair? Will it build goodwill? I say no, it will not."
Petersen again asked the Rotarians, "Are you your brother's keeper?" "Well," he said, "in some ways you are because your tax dollars are also footing the bill for many of the same physicians who are involved in this project who are being paid a stipend from the hospital and would be competing against the hospital."
In conclusion, Petersen spared no words: "It (the center) is unethical. It should no longer continue."
Officials from the hospital and the surgical center proponents have been in a battle about the surgical center since the first of the year. The hospital officials have announced they will appeal Carty's decision in court.(See "Hospital Will Appeal Commissioner's Decision on Surgical Center")
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