Moncton Hospital Doctors banned from Dumont Hospital breast centre;
Proposed Centre of Excellence will only allow doctors from Dumont Hospital
If the breast centre of excellence at the Dr. Georges-L.-Dumont University Hospital Centre goes ahead as planned, breast specialists from The Moncton Hospital - including oncologists and radiologists - won't be able to treat patients at the facility.
According to the Vitalite Health Network, which administers the Dumont Hospital, it will be only doctors who have privileges at the hospital who will be able to work at the centre. Essentially, having privileges with a facility allows a doctor to practise at that hospital.
Dr. Heather Tait, medical director of the breast health program at The Moncton Hospital, doesn't have privileges at the Dumont, which means she won't be able to work at the breast centre of excellence should it be solely affiliated with that hospital.
Neither will general surgeons, the doctors who perform breast surgeries, said Tait; nor will radiologists, the doctors who read mammograms, MRIs and ultrasounds and perform biopsies.
The Times &Transcript has requested a list of oncologists at The Moncton Hospital and the Dumont Hospital who have privileges at both hospitals via an access to information request form from the Horizon and Vitalite health networks, respectively.
The Moncton Hospital is administered by the Horizon Health Network.
Tait first came to The Moncton Hospital as a resident with Dalhousie University's surgical residency program in 1997, coming again as a resident in 1999. During this time, she worked closely with general surgeon and breast specialist Dr. Roger M.J. Roberge, who is also a founding member of the board of directors of the Atlantic chapter of the Canadian Breast Cancer Foundation (CBCF). Roberge had a very busy breast practice, according to Tait.
She said Roberge knew of her interest in breast surgery and recruited her to come back to The Moncton Hospital when she finished her residency.
When she did so, she applied for a fellowship - an extra year of training in cancer treatment - and worked at the University of Toronto, the Women's College Hospital and Sunnybrook Hospital in Toronto from August 2002 to August 2003.
One month after she started back at The Moncton Hospital in September 2003, Roberge stopped performing surgeries, and Tait picked up most of them. Tait said other surgeons perform breast surgeries at The Moncton Hospital, but as the medical director of the breast clinic, it's a big part of her practice.
Tait was one on seven doctors at that hospital who wrote an open letter to the government and Vitalite recently proposing a collaborative, stand-alone breast centre, with the purpose of allowing doctors from both Moncton hospitals to have access to the centre of excellence.
Both hospitals currently have breast clinics or programs, which are smaller in size than the breast centre of excellence would be, but Tait said, "Right now, there's no overlap. I don't go there and do clinics, and they don't come here and do clinics."
In an email to the Times &Transcript late last Thursday afternoon, Luc Foulem, a spokesperson for Vitalite, said, "Doctors practicing at the breast health centre will be those that have privileges at the Dr. Georges-L.-Dumont University Hospital Centre. ... As in any health care program in all health care institutions, doctors practice in the facility or the facilities where they have privileges to do so and physicians are well aware of this."
Vitalite and the Department of Health have yet to make an official announcement either about the establishment of the centre of excellence, or a timeline for the project. However, in a December 2011 press release, a breast health centre to be located in the Vanier Building of the Dumont Hospital complex is listed as an infrastructure project for the 2012-2013 fiscal year.
In an earlier email to the Times &Transcript last Thursday afternoon, Foulem said the breast health centre will be located at the Dumont, and "will benefit from having a multidisciplinary team of specialists having a high level of expertise already on site." He said the team has been together for about 10 years.
Despite this, in the earlier email, Foulem said "collaborative and complementary work will continue between the medical team of the Dr. Georges-L.-Dumont University Hospital Centre and the medical teams of the other hospital facilities involved in breast cancer treatment across the province."
There are a few departments with surgeons and specialists who have privileges at both Moncton hospitals, and therefore are able to work at both locations when needed. Tait said these departments included plastic surgery, orthopedics and the ear, nose and throat division.
Breast specialists who don't have privileges at the Dumont may have to let go of some patients, too.
When a family doctor refers a patient to see a breast specialist or surgeon, it's the doctor they're choosing, not the hospital. If there's a transfer, the patient becomes a patient at the hospital where their surgeon works.
This means patients who see Moncton Hospital doctors but eventually need the services at the centre of excellence would become patients at the Dumont.
"They wouldn't be my patient anymore," said Tait.
The centre will be accessible to French- and English-speaking patients.
For Tait, the location isn't the issue, but rather that the centre not be exclusive to those with privileges at the Dumont. She believes a breast centre of excellence is a good idea as it would allow the best treatments for patients, physicians and staff, but still thinks a joint, stand-alone centre is the best answer.
"They have expertise and we have expertise so ... why not collaborate?" Tait said.
Issues surrounding breast care in Moncton began in October 2007, when doctors at The Moncton Hospital asked the government to purchase a second MRI, but were unsuccessful in their request. In August 2009, the doctors said the Department of Health froze new radiology programs, but then, seven weeks later, then-minister Mary Schryer announced financial support for a breast health centre at the Dumont and the purchase of an MRI.
These announcements, the Moncton Hospital doctors said, "significantly undermined the efforts of the department of health and their credibility to control health care costs."
According to the Dumont's website, in October 2009 Schryer announced the government was investing "$1.8 million in operating funding and one million dollars in equipment over the next three fiscal years to support the creation of an integrated breast health centre."
In November of the same year, the doctors wrote a private letter to the government about the funding.
The minister of health and department officials met with The Moncton Hospital's doctors in mid-November 2009, to hear a proposal similar to the one they released earlier this month.
The seven doctors from The Moncton Hospital who signed the letter are: Dr. Hazem Assi, department chief of oncology; Dr. Louis-Jacques Cartier, medical director of laboratory medicine; Dr. Paul Goobie, clinical department head of surgery; Dr. Rick Morton, president of the medical staff; Dr. Jeff Mowat, clinical department head of radiology; Dr. Karen Silver, clinical department head of family practice; and Tait, the medical director of the breast health program.
GinaBeth Roberts Times; Transcript. The Times - Transcript [Moncton, N.B] 30 May 2012http://search.proquest.com/news/docview/1017608593/13705FB51444084183A/4?accountid