Program to put focus on underserved population
Eastern Sussex County residents who require heart surgery or interventional cardiac procedures will soon be able to receive those services locally. In a matter of days, doctors at Lewes’ Beebe Medical Center expect to begin performing heart surgeries and interventional services, such as angioplasties and stenting procedures, normally used to open blocked coronary arteries soon after patients suffer heart attacks.
Coastal Point • JONATHAN STARKEY:
Beebe Medical Cener's cardiac surgery team is ready to get a jump start, offering heart surgeries and interventional services.Prior to the inception of Beebe’s cardiac program, residents living in eastern Sussex County who required such services would have had to leave the area to receive them. Peninsula Regional Hospital in Salisbury, Kent General Hospital in Dover and Christiana Care Medical Center in Christiana currently offer cardiac surgery programs.
“Cardiac surgery really adds to a hospital’s capacity to take care of critically ill patients,” said Dr. Fernando Garzia, a 14-year heart surgeon and director of Beebe’s new cardiac surgery program. “The most common critical illness people have is heart disease.”
Jeffery Fried, president and CEO of Beebe Medical Center, said center officials had planned to introduce such a program for years to fill a void in an area that boasts a large elderly population.
According to Beebe population numbers, residents older than 65-years-old account for roughly one quarter of the population in the medical center’s primary service area. And by some estimates, more than 100 people leave the area monthly for cardiac surgeries and interventional procedures.
“We always look at what services we’re providing, and what services we’re not providing and maybe we could provide,” Fried said. “More and more, people were leaving the county for some kind of advanced cardiac services we couldn’t provide.”
Garzia, who expects to perform between 200 and 300 heart surgeries annually at Beebe, will be complemented by Dr. Stephanie Goodwin, who has been performing interventional procedures for more than 10 years. She expects the hospital to perform up to 50 such procedures monthly, a prospect she called “potentially very substantial.”
Beebe added 37 additional staff members — including physicians’ assistants and a cardiac anesthesiologist — and invested more than $12 million to initiate the program. Like many other start-up programs, Beebe has also partnered with a larger cardiac surgery operation – in its case, Christiana Care, the hospital to first introduce cardiac surgery to Delaware, in 1986. The centers already partner on a cancer program.
“They’ve got an excellent reputation,” Fried said, and, “They’ve been a great partner. We thought it was another way to add to the relationship.”
Complementing services
According to Garzia, bypass operations — in which the surgeon reroutes blood flow to the heart using veins or arteries from other parts of the body to circumvent blockages — and valve replacement or reconstruction procedures are the most commonly performed heart surgeries. Working out of a Lehigh Valley, Pa. hospital, where he helped establish a cardiac surgery program, Garzia performed 150 to 250 surgical procedures annually.
He expects to top that number at Beebe. Goodwin, though, will complement the surgery program by offering patients less-invasive, and normally more attractive, heart procedures.
Angioplasties and stenting procedures require no incision; instead, doctors use catheters inserted through the groin to send either balloons or wire mesh stents through vessels to the blocked artery to prop it open, at least temporarily relieving the problem. Performing such a procedure inside of the first 90 minutes after a heart attack dramatically reduces the chance of long-term effects, Goodwin said.
“It’s an appropriate first step,” Goodwin said, implying, though, that sometimes it is no substitute for open-heart surgery. “Anything you can do to prevent surgery is a good thing,” she added.
Beebe officials could previously diagnose heart problems at their Lewes campus but could not treat serious problems surgically or through interventional procedures. Local cardiologists, who, by all accounts, are ecstatic about the new opportunities, said adding the services will upgrade the level of service in all areas of the hospital.
“This will attract different cardiologists and a higher level of service and it will be good for the community and the hospital,” said Dr. Kenneth Sunnergren, a cardiologist with Cardiology Consultants in Millville who frequently works out of Beebe. “Every service the hospital offers will improve. It will attract the best.”
Dr. Habib Bolourchi, Beebe’s chief of staff and a cardiologist with Rehoboth-based Henlopen Cardiology, attempted to put that claim into perspective. Doctors will be more apt to perform a prostate surgery at Beebe, for instance, knowing that if something goes awry and the patient suffers a heart attack, the hospital now has the resources to handle that problem, he noted.
“We have the expertise locally to take care of that,” Bolourchi said. “The benefit to hospital as a whole is that (the cardiac surgery program) raises level of care even in other areas locally.”
Underserved population
Cardiologists in eastern Sussex County have been sending roughly 1,400 local patients outside of the area to receive angioplasties, stenting procedures and bypass surgeries annually, according to Sunnergren.
That amounts to an average of more than 100 patients a month and almost four a day.
“The numbers are staggering,” Sunnegren said, adding that the numbers do not include those who need valve operations. “That’s a huge number of people.”
The numbers, while “staggering,” are perhaps not surprising given the amount of elderly residents living in the area, many of whom were attracted by retirement at the beach.
According to Beebe population projections, 28,351 of Beebe’s primary-services residents in 2008 will be older than 65, the group most likely to need heart surgeries and interventional procedures. The 2008 number represents 24.3 percent of the projected population and is up from 23,009 in 2003.
“What was not appropriate was they had to travel to another hospital they didn’t know and see doctors that they didn’t know,” said Bolourchi, who called the new program “a dream come true.”
“It caused a lot of stress for the patients and their families,” he added. “(And) there was delay associated with it. Now with the surgical program, we don’t have to do that.”
Garzia agreed, saying that patients are more comfortable receiving treatment within their communities.
“Elderly patients, in particular, are attracted to getting care where they’re friends and family live,” he said. “I think they put a high value on that. To have the care on their community hospital is much more valuable than hopping on a plane.”
Sunnergren, who talks to patients daily, said his are naturally excited about the prospect of receiving all levels of cardiac treatment locally. Speaking on behalf of all of his colleagues in the area, he also said area cardiologists are unified in their support of Beebe’s new program.
“I’m surprised this hasn’t happened sooner but I’m happy it’s happened now,” Sunnergren said. “It’s clearly a positive thing for the area. It’s not about making money. I’m as busy as I can possibly be. Every aspect of treatment will improve. It’s good all the way around.”