Dr. Noah Chelliah, Grand Forks, column: Bottom line is that Altru squelched competition
April 28, 2012 at 7:05 pm in Grand Forks Herald
Altru administrators insult our intelligence by claiming that all of a sudden, they realized they needed the exact same space that Doctors Hospital had been preparing to use as a competing hospital, then they decided to buy the space a day or two before it was to open. Continue Reading
Way to go Dr. Chelliah! You’re telling it like it is!
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Finally!! Someone WITH CREDIBILITY dares to tell the truth about Altru! Kudos to you, Doctor!!!
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Great article Dr. Cheliah. It’s nice to read the truth instead of the spin Altru puts out. If anyone reading this is in need of an outstanding cardiologist I highly recommend him.
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Dr. Cheliah has been around a long time. His opinion should not be taken lightly.
Kudos Dr. Cheliah!
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In an earlier thread I described how Altru tried to restrict the admission privileges of independent physicians until they realized they did not have enough specialists of their own to provide coverage & bacpeddled. Dr. Chelliah as well as a nephrologist & orthopedic surgeon were the ones involved.
From what he is saying they have improved their stable of in house specialists to the point they are playing the same old games again. Very sad because healthcare economics being what it is, there will come a time when they will need his cooperation again.
I am not a big fan of tit for tat in business relations but I am sure he will remember this in the future.
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Dr. Chelliah,
Thanks for sponsoring Lawrence Welk on PBS. I appreciate it.
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Wow, four people in ND dislike Lawrence Welk.
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Who is John Galt?
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what is PBS?
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It’s what women get once a month.
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Pretty B!tchy Syndrome
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So PBS is not some type of medication? I’m so naive I would find it more entertaining to watch Mr. Rogers on LSD than Welk on PBS.
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I like Welk on SNL. Kristine Wiig makes me laugh.
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All joking aside, I’m sure plenty of his patients and Gene appreciate his generous donations to PBS.
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Ron, don’t waste your time trying to insult and control the comments of a physician whom you fail to refer to as a doctor and can’t even spell his name correctly.
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Altru waited until the eleventh hour to purchase ‘needed space’ which had been on the market for quite some time. This not only squelched competition but resulted in the lose of many local jobs. People, not positions, REAL people, had been hired to work at the new facility. They had 24 to 48 hours notice they did not have jobs. What message does this send to people who don’t want to march to the Altru drum?
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Of course, they waited until the last moment to purchase it… they had to see which employees left their organization to work at the new hospital…as soon as they saw the whites of their eyes, they fired them — but good! Yep, real good business practices, Altru! Why don’t you spend your money on improving patient care at your own damn place???
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All in all, if those words hurt those at Altru that they were directed at, I’m glad. They’ve hurt the rest of us enough already.
Altru, you can kiss me goodbye. I’ll make sure I never touch you again, and do my best to make sure everyone I know doesn’t. You’ve shown you don’t care enough about us to even give us a choice in healthcare from Grand Forks. That’s enough for me to worry about what kind of care you’re providing, which is likely only as good as what you want to provide, because you feel like like you shouldn’t have to compete with anyone else.
Others who agree, comment below.
Out.
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That is not Dr. Chelliah and you have no right to insult the man with the accusations you just made. I would appreciate it if you went back to either the ACSC board or the UND board and continued your petty nonsensical rants on one of those.
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very similar style to your posting….well except you often seem to be missing facts. No sense in digging up facts Ron, it will cramp your style! Carry on
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Ask any comedian…Timing is everything…..And Altru’s timing really makes it tough to buy this nonsense that they weren’t doing it to eliminate competition……It’s like some elderly woman once said… “They say they can erradicate dog poop so it’s germ free and edible….But any way you look at it….It’s still dog poop….”
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Well said Tundra, well said
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Dr. Chelliah has been my doctor since 2006. After my husband was locked-out of the ACSC factory Dr. Chelliah gave me six months worth of medicine for my heart condition. It would have cost me $2400. He’s a good man and a great doctor. Now leave him alone…for my sake.
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If true…I bet the pharmaceutical company that gave HIM the medication would love to hear about THAT!
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Big Pharma drops free samples all the time, nothing illegal with that. Dr. Chelliah is a well respected Cardiologist who has been serving GF and the surrounding communities for a long time. Altru’s Cath-Lab was established with the help of Dr. Chelliah. The Cath Lab is a huge money generating machine for Altru.
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Hello Ron, This is an opinion area voices just an FYI.
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I never said he wasn’t a good man. He states in his letter altru has hurt his buisness and his on call status. He has a huge conflict of interest along with the fact he uses all hearsay that he cannot back up in his letter, leaves me to be skeptical of what I am reading. I am glad he has treated you and your family well and I am glad we have a doctor that was willing to do that for you.
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Yep…it’s business and he who has the most money usually wins. I’m sorry that snapped at you.
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Ron you are almost as psychotic on this issue as Always is about his sacred cartoon. Nothing Altru did was illegal, it just smacks of impropriety.
Altru touts itself as a community resource, when it does not behave that way they pay the price in terms of public confidence & trust.
This is one of those times.
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Where’s the outrage at Doctor’s Hospital for SELLING the facility a few days before it was suppose to open? Who was Doctor’s Hospital anyway? Weren’t they an out of state, for profit, entity? So they set up a hospital to create competition in GF health care and then what–decided they could make a huge profit by selling it to Altru so the heck with giving people a choice in health care and creating competiton—-they went with selling it to Altru and took the money and ran. Is that what happened? If so, I find that to be much more disturbing than the fact that Altru bought it. Seems to me that buying it was good business sense on Altru’s part—selling it was: “Selling out” — the compromising of integrity, morality, or principles in exchange for money. In all fairness, why isn’t Dr. Chelliah addressing that instead of attacking Altru where he makes rounds in THEIR hospital to see his patients, does procedures in THEIR cath lab and sees patients in THEIR emergency room. Since his private practice has been thriving for 13 years, I would think he would be somewhat grateful to Altru for allowing him to use their facility since he seems to have so much distain for them. Where’s his distain and everyone elses for Doctor’s Hospital for selling out?
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FOR THE LAST TIME…..DOCTOR’S HOSPITAL DID NOT SELL OUT!!!!!! KEVIN CHRISTIANSON, OWNER OF PACES LODGING AND PROPERTY RESOURCES GROUP IN FARGO SOLD OUT. DOCTOR’S HOSPITAL WAS MAKING IT’S MONTHLY LEASE PAYMENTS ON THE PROPERTY TO PACES LODGING AT THE SAME TIME THAT PACES LODGING/KEVIN CHRISTIANSON WAS MAKING A BEHIND THE DOOR DEAL WITH ALTRU’S UPPER ADMINISTRATION. DO YOU THINK IT’S JUST A COINCIDENCE THAT ON THE VERY DAY DOCTOR’S HOSPITAL WAS GIVEN ITS FINAL LICENSING APPROVAL, ALTRU ANNOUNCES THEY ARE BUYING THE BUILDINGS? DOCTOR’S HOSPITAL WAS GIVEN 24 HOURS TO COME UP WITH $14 MILLION DOLLARS OR VACATE THE PREMISES BY MARCH 1ST. THEY WOULD HAVE ALSO HAD TO COME UP WITH AN ADDITIONAL $46 MILLION BY JUNE 1ST.
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Well, you’re almost right… why doesn’t someone look into the real investor who was supposed to have finished that hospital four years ago…Kevin Christianson of Fargo… he ran out of money to finish the place, used short cuts to get the buildings built, made “individual deals” with tenants for rent so that each independent pays a different rent and a different lease agreement… no one has mentioned his name ONCE since this whole thing happened… where is he??? He’s the one who is most guilty for ruining Aurora and its hospital… Altru is second for jumping at the chance to ensure no one else could buy it!!! And then Altru has the guts to ask for “bonds” to pay for it… why, their yearly “sole healthcare facility” from the federal government (which is in the millions, by the way) will pay for their new buildings in no time… who do they think they are kidding??
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Competition – Try it Altru – You might wind up liking it. I lived in Grand Forks and used the Altru (formerly United) system for many years. I now live in a larger city in the Ozarks of Missouri where we have two very large and both thriving health care centers. They work very well together and their competition has served the area well. The city rotates them for ambulance/helicopter dispatches and they will deliver the patient to their hospital of choice – no problems. If one builds a new specialist facility, the other soon follows. When the tornado in Joplin, Missouri took out it’s major hospital, both of the hospitals in this town jumped right in to take up the slack. The best part is that both of these medical systems strive to give this community the best possible service and account for a majority of the jobs in town. As I said – Competiton – try it Altru – you may like it and your town (and region) darn sure will.
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Very few doubt the excellent care given by the majority of Altru health care providers . The concern I have has to do with what is transpiring in our community . Independent health care providers have been and continue to be directly (Altru not sharing call with independents), and indirectly (not having independents as PPOs without a large co-pay). And, now, we see this last minute take over of a medical complex that was days away from opening it’s doors to the public. Dennis Reisnour refers to taking care of the Altru ‘family’ of 4,000 but what about the other 49,000 people who live in our community? Don’t they deserve a choice, a voice?
” One should always play fairly when one has the winning cards. ”
Oscar Wilde
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I think there have been a lot of interesting and thought provoking comments listed. But one thing I don’t understand is why do people think it is Altru’s job to share call with independent physicians. Presumably that has happened in the past because it was beneficial to both parties. But if Altru hired enough cardiologists to cover their own service why would it make any business sense to continuing to share with a non Altru physician? Just like if the independent cardiologist hired 2 more partners – they may have decided to end sharing call with Altru even if it left Altru in a tight spot.
Also I assume with Altru’s health insurance plan that it is less expensive for Altru to offer their employees services within Altru. If the patient chooses to use service outside of Altru without an approved referral it will cost him/her more. There is still a CHOICE to use an independent physician or go to Fargo or EGF or wherever, but why would it be Altru’s responsiblity to fund that choice and not the patient? I imagine that Sanford’s health plan is similar – cheaper to use Sanford, more expensive to CHOOSE to go elsewhere.
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Why should altru “share call” and have them as PPOs, if they are imdependent? Definition of independent~ 1.Not subject to another authority or jurisdiction 2. not relying on others for aid or support. altru does not have to share call or include them as PPO’s they are independent. By assuming altru owes these independent doctors anything is the complete opposite of what independent stands for. If what vince carpenter is saying is true dr chellian might need a true taste of what independent means, but it sounds to me like altru has been very cooperative of sharing their building and resources to this independent doctor.
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Physicians share call in order to provide a medical service to the community. Sharing call amongst specialist ensures the community, for example, a cardiologist will be available to them 24/7 in the event they have a cardiac emergency. As flyingnurse pointed out, Dr. Chelliah’s taking call was not an issue when Altru needed an extra body to ease the load on their in-house cardiologist. It was an asset, it was a selling point for Altru when recruiting cardiologists to Grand Forks; “You’ll only have to be on call XX hours per week because XX number of cardiologists share call.” Sharing call amongst different medical clinics/independents is not a new concept. It is commonly practiced in all type and size communities, nationally and internationally. To go from having shared call in the past and then arbitrally stopping could, to some, smack of coercion.
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See my above comment. The reverse is also true. The independent cardiologist would be happy to use Altru when it makes good business sense for him. If he hired on more partners he (I assume) would be happy to sever ties with the competing cardiologists at Altru and cover his own practice – whether it hurt Altru or not. Who would fault him for that? It makes good business sense and it is a business.
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Hillary: you are getting close to the answer. Altur is most certainly NOT required to share call. Stop for a minute though and look at the details: Chilliah has been independent for 13 years. Why did they share call for 12 of those years? Altru needed him.
For many years Altru was unable to staff several specialists in numbers great enough to cover ER call and allow their own doctors time off (what is the purpose of bringing in $250,000 to $300,000 a year if you don’t have time to spend it). They relied on these independent physicians to fill in the gaps.
Cardiology, Critical Care, Renal, and Orthopedic Surgery are all examples of independent specialists that helped pick up Altru’s slack. Is was a good system and worked well.
Now, Chilliah and other specialists will be required to bring in other partners. That is good for Grand Forks (choice is never bad when it comes to healthcare – never) but bad for Altru. Chilliah does not take away business from Altru, they both have been around long enough to have accomodated each other. Any new cardiologists will indeed be taking away from Altru’s existing pool of patients.
Under the cut off your nose to spite your face category. Chilliah is independent and does not want to affiliate with Altru or any other conglomerate for that matter. That said, if he enters into an agreement with Sanford where they cover his vacations, that would allow those Sanford doctors to refer patients to the EGF clinic for followup; removing them from Altru’s base (most of Chilliah’s patients use Altru for their other needs).
The Machiavellian permutations can get pretty wild.
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That is true with any symbiotic relationship – presumably when both parties get something out of the deal it works well. When there is a shift in need the agreement changes. (One of the 2 parties hires enough people – sharing call doesn’t seem symbiotic any longer.)
I would disagree that when sharing call the independent cardiologist does not take business away from Altru. Of course he does, because I assume any time someone comes in to the ER who doesn’t have a patient relationship with a cardiologist will be assigned to the cardiologist on call. When the independent cardiologist is on call he would get the patient and if he did a good job all of the follow up too.
If Altru doesn’t share call – and you come in and don’t have a cardiologist or don’t request the independent cardiologist – you will be assigned to the Altru cardiologist on call. Presumabably if he/she does a good job you will continue your care with Altru.
It makes good business sense in that regard to discontinue sharing call once it stops being beneficial to both sides.
I also wonder if there is animosity between the independent cardiologist and Altru that preceeds this? It would make sense for Altru to cut ties with someone that is disruptive or hard to work with. (I am not saying this is true – there are just some aspects of the relationship that we are not privy to which also may make sense of why there is no longer a good working relationship between the 2.) As with all things the truth probably lies within the middle – neither is perfect and neither without some blame.
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Very good questions Hillary. Chilliah and Altru have always had a cordial, yet strained relationship. Altru has always been borderline hostile to the independent physicians in town for many of the reasons you outlined.
Altru walks a fine line. Although I imagine they could deny admission privileges to the independent physicians, that would raise serious community service vs. denial of trade questions that undoubtedly end up in court. At the present time it is also against the hospital medical staff bylaws.
Altru relies on Chilliah’s admissions. When a patient needs admitted, he admits to Altru. If he started admitting elsewhere, Altru’s bottom line (especially in the ICU and on the telemetry floor) would suffer.
Altru wants everyone with MD behind their name to be an Altru employee. There has always been a percentage of specialists who will flat out tell you they did not go to medical school to be someone else’s employee (I sure wouldn’t).
Chilliah is also very successful. That building across the street from Altru was not built with the proceeds from dissatisfied customers.
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I doubt it was arbitrary.
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Definitely not arbitrary. Putting the squeeze on non altru providers has been a standard business practice all along. Altru does not make money when people and their payments leave the system.
It is more than doctors and procedures. Altru clinic is also Altru lab and radiology. Independents tend to have agreements with outside lab and xray.
It is a trickle down effect.
One of the largest patient disatisfiers Altru has is billing. Altru management cannot figure out the bills half the time, even for their own families. This has been a problem for over a decade.
When a patient goes someplace else, receives good service, gets better physically, AND can understand their bill: it does not take an MBA to figure out where they will go next time they are sick.
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I believe that’s why the docs from Valley Bone and Joint left Altru…they were sick of working weekends and being on call…and yet their kind of business brings in all kinds of dollars, so Altru is willing to work with them… who’s cherry-picking now?
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Shouldn’t you direct your anger at kevin christianson? If. what lottabs says is true he is the one who sold the buildings. Doctor’s hospital couldn’t even invest enough in itself to own its own facility.
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According to an article in last September’s Herald, a group out of Indiana bought the hospital.
Friday, September, 16, 2011 – Grand Forks Herald – Business
Indiana group purchases Aurora Hospital
Doctors Hospital to open early next year
The mothballed Aurora Hospital building in south Grand Forks appears to be on its way to finally opening to the public. Physicians Hospital System, an Indiana-based network of physician-owned health care facilities, has completed the purchase of the Aurora Hospital building in the Aurora Medical Park.
Yet lottabs is telling us a group out of Fargo owned it and sold it.
Well Ron, I guess no one is mad at whomever sold it because no one knows for sure who owned it.
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The problem is you got your facts from the GF Herald which is basically a gossip rag owned by Forum Communications with headquarters in Fargo, ND. Their specialty is cut and paste journalism followed by corrections at a later date. Keep reading Vince…you will uncover the real story about who owned the building. The rest of us already know but we will wait for you to catch up.
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I don’t really care who owned the building. The fact is they SOLD it. And Altru bought it—good business sense. Don’t like it? Move some place where there’s more than one hospital and a newspaper to your liking.
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I will do as I please and I’m not going anywhere.
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Good God Vince, not another ND who believes the answer to everything is “if you do not like it move.”
How do people like you make it through life? An honest sincere question.
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Nurse? Where would you like to be employed when you graduate?
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UND or Northland. Mayville State would be primo. I will consider something in Fargo or maybe Lake Region in Devil’s Lake. I am not interested in the oil patch and Bismarch while a possibility is a little far from my grandkids to make moving back all that appealing.
I am back for the grandbabbies, that means something within a few hour radius from GF
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Obviously Crookston and Moorehead are in the running as well
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If you were looking for a comment about how I will be back at Altru, sorry to disappoint. As I said before, I have nothing against Altru. It is a good place run by good people who care very deeply about the citizens of GF.
This is not binary: either/or. You can be a good person and care about the community and give great care to your patients and still have questionable business practices. It is possible to have both.
I have worked very hard to not be a nurse anymore. I have been a nurse for 25 years; 30 if you count my time on a box (ambulance). I do not want to be a nurse when I am 70, and you do not want me taking care of you in my dotage either. Since social security will be in worse shape than me by then, I have been trying to position myself for career number two.
I won’t stay in GF if it requires being a nurse simply because I have a very nice job as a nurse, there is no reason to move back for that.
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nurse you stated it yourself if chillian or anyone else wants full access to the altru facility they would need to be employed by altru. They chose to be independent and have to live with the struggles. It sounds like altru and chillian had a nice cooperative agreement for many years. I do not know the circumstances that led to their agreements to break down over the past few year, but it is the cost of being an independent. Dr chilliah sounds like he is very good at what he does, but that alone does not give him full access to another buisness facility. He chose the independent road and now he has to face the struggles.
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Ron…your comments are not worth a response. I have decided to shun you. It’s your loss…not mine.
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Ron: See my post above about the Altru tight rope. Remember Altru bills itself as a community resource. They receive some very concrete financial support because of that.
Altru cannot outright deny access without losing their community status.
In California Kaiser Permanente owns the doctors, the hospitals, everything. It is a wonderful system for day to day care (they are very progressive when it comes to wellness, you can almost always get a same day appointment to see your doctor, good price on drugs, free routine health screenings, etc.). They are in fact an insurance company that keeps cost down by keeping literally everything in house.
Outside physicians do not practice at Kaiser.
Altru is not Kaiser. It is trying to combine the best orf Kaiser with the best of a community hospital. Sanford is similar. This hybrid system by definition will have many peculiarities not found in an HMO (Kaiser) or a community hospital.
HISTORY QUIZ: Why does the name Kaiser ring bells?
Hint: Think liberty ship
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Kaiser rings bells because it was a huge aluminum/steel company. The original hospitals were founded for its employees.
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Exactly. GM had a similar gig for a while. WWII was won in no small part because of Kaiser. He figured out how to cut the time it took to produce a ship from 6 months to one week. A few are still afloat.
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Thank you, that explains a lot nurse. Its sad but understandable why their relationship may be strained. I understand altrus stance, they will open the door but you can’t blame them for being difficult. On the other handhe wants to be on his own but can’t do everything without altrus facility.
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Exactly. It is free enterprise at its finest.
As I have said many times before, I am not sure our healthcare system should be based on market forces. There is an argument to be made that everyone is deserving of healthcare simply because they are alive.
Since the voters of this nation have chosen the market, there are certain rules that must be followed. The fact that competition is almost always good, and that choice is ALWAYS (absolute used intentionally) good come to mind.
People need to remember that healthcare is a very cyclical operation. It is not unreasonable to hear that in 6 months from now one Altru cardiologist went out on long term medical leave and another left for more money and a more amiable lifestyle someplace south, leaving Altru short of specialists once again. They will then be asking the independents to up their ER call beyond that which is required by the medical staff bylaws.
Healthcare in ND is unique. If you took a map of ND and put a pin everywhere there was a physician, you would notice swaths in the middle of the state several hundred miles long with no MD or DO.
If you go to the state’s website and start computing the number of specialists in ND per capita compared to other more populace states, and then put an overlay over that same map on how far apart they are … you get the point.
We need all the doctors we can get, regardless of who pays them.
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You made some good points about dr chelliah being vamuable to altru and I don’t disagree with you that it is good for him and altru to have a cooperative agreement. It sounds like it is not what it used to be and there could be many reasons for it that the public does bot know about. However I do find it very unprofessional of him to write a public letter
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In which he completly bad mouths altru. A corporation that he should be cooperating with and making enemies that could further strain his relationship with altru. Just because you are talanted in your field doesn’t mean that you automatically can publicly do or say whatever you want about a healthcare facility and relationship that the community needs.
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Sorry for the misspelling my keyboard is really acting up tonight.
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Flying nurse, would chelliah be able to practice the same way he does (here with what sounds like full facility access and (in the past) on call) in a large metropolitan facility? Or would he have to affiliate himself with a large metropolitan facility?
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The problem is timely patient care. It’s not the fault of hospital support staff like nurses, techs etc., but If a patient has an independent Dr…. Altru IS the only hospital in town. From my personal experience, when lab tests and screens are done on the patient while staying in the hospital, my independent Dr. can only access the results by coming into the facility. Therefore cannot check the results and give instructions in a timely manner if needed.
Sometimes this can make a huge difference in patients health and comfort to have to wait for the independent Dr to get done seeing patients and come into the hospital at the end of the day.
Nurses have even told me that IF I had an Altru Dr…things would be different.
Altru being the only hospital option in town needs to be more user friendly to Independent Drs. AND their patients.
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mc, That is not completely true. When any independent provider orders tests performed at Altru on any of his/her patients, results of those tests are sent to the ordering provider as soon as they are available. Results are disseminated through a variety of means, including fax, mail, phone calls, printers set up in the provider’s office by Altru, and in some cases directly through the computer system as many independent providers are linked directly into the hospital’s computer system. So if your independent provider told you they were not able to access results of tests or procedures that they ordered, they were not being completely honest with you. Now if the tests were ordered by an Altru provider, that’s a different story, as the results are sent to the ordering provider and for confidentiality reasons cannot be sent to someone else without the appropriate release of information documents being signed.
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I don’t really see your point. Isn’t it the independent doctors reponsibility to get the information in a timly matter. If he is busy seeing other patients at his own facility how is that altru’s fault. They have the. information available to the doctor and I don’t know the real answer but would assume there are some legal issues when it comes to who and how they can release medical records to.
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When you have a HEART ATTACK RON you WILL SEE the DIFFERENCE! UNTIL THEN…..
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We love you Dr. C!!
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Hey tj… I really want to talk to you minnesotarick@yahoo.com
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