Questions raised about closure of popular clinic

A new North Valley Hospital practice with a three-month patient waiting list is set to close this month after administrators decided not to renew its contract. The doctor that led the clinic said the abrupt closure has left him and his patients with unanswered questions.

Dr. Daryl MacCarter was welcomed to the North Valley team in January as the hospital’s newest clinic, North Valley Rheumatology. Last month, its patients received a letter thanking them for the support and notifying of the clinic’s upcoming closure Nov. 30.

“I want to know why,” MacCarter said. “I have more than 350 patients who have to wait months to be seen. It’s the most successful practice I’ve ever had. But the merger happens, and all of sudden I’m told I don’t fit into the plan anymore.”

MacCarter was referencing an affiliation agreement that brought North Valley under the umbrella of Kalispell Regional Healthcare. The hospitals’ governing boards finalized the affiliation in March.

Both hospitals have stated their collaboration is an affiliation, not a merger.

In March, Kalispell Regional Chief Executive Officer Velinda Stevens said it made sense for the hospitals to offer coordinated care. She said that under the affiliation agreement, both facilities would continue to operate as separate critical access and acute care hospitals, with an increased effort to share physicians and staff between the establishments.

Neither hospital responded to a request to explain which administration is in charge of reviewing employee contracts when they’ve expired.

Likewise, neither hospital commented on which organization decided not to renew MacCarter’s contract.

MacCarter said he received news of the clinic’s closure from Stevens with the North Valley chief executive also present. Stevens was not available for an interview.

Catherine Todd, the senior director of community relations with North Valley, said all communication regarding MacCarter’s practice was under the charge of Kalispell Regional officials.

Jim Oliverson, vice president of Kalispell Regional, said neither hospital could discuss why the practice was not continued.

“It was a year contract and at the end of the contract, it was over. I don’t know what the expectations were for the contract — contracts are confidential,” he said.

He said Kalispell Regional offered MacCarter the opportunity to lease the space he had operated out of as a private clinic.

“He could keep the staff, the patients, space and we’d help him acquire a practice manager and whatever else he needed to continue,” Oliverson said.

MacCarter said at 70 years old, going into practice for himself didn’t feel like a valid option. He said after consulting a public accountant, he discovered the transition would cut his income by two-thirds.

MacCarter is certified in musculoskeletal ultrasound. He is one of the few Montana doctors using ultrasound imaging to diagnose rheumatologic conditions and perform joint and tendon sheath injections — a procedure he said costs less than $300.

“I didn’t make the hospital enough money because I treated in a way that didn’t involve trafficking people to the surgery room,” MacCarter said.

MacCarter said he approached Kalispell Regional five years ago to work with them as an affiliation. He said hospital officials rejected the idea, stating they already had affiliated rheumatology clinics.

He said after splitting time between his Montana home and Idaho practice for years, he approached North Valley about opening a clinic.

When the affiliation was finalized in March, MacCarter said he worried his time as a doctor with North Valley would end.

“I’m going to miss my patients, this is a huge disservice to them and the doctors who referred them to me,” he said. “For a hospital to set someone up with a clinic, then pull out the rug and walk away within a year, that’s not ethical or good for patients. I would still be at North Valley if there wasn’t a merger.”

Curt Lund, the Kalispell Regional Board of Trustee chairman, said he was not allowed to comment on MacCarter’s situation. But, he said when the affiliation was announced, Kalispell Regional made it clear positions would not be cut at North Valley due to the collaboration.

He said the hospital has stood by that promise.

“I worked with the North Valley board for three years before this. The transition is going very very well, there just are no issues,” Lund said. “Because of the way we handled it, there will be no changes at North Valley, only strengthening services.”

He said with 400 doctor’s in the valley, “at one point or another, we’re always dealing with an issue of some variety.”

Orlan Sorensen is one of MacCarter’s patients who is upset the practice is closing.

Sorenson said other doctors have suggested surgery as a solution to issues caused by his arthritis in his hands and knees. He said at the North Valley clinic, his pain is gone after a treatment every few months by MacCarter.

Sorensen said he hopes to get one more appointment with MacCarter before the practice closes.

“After that, if I want the same treatment I’d have to go to Spokane,” he said. “Like a lot of people, I’m frustrated we weren’t given any answers. If he only had 100 patients I could see it, but you can’t even get in there.”