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San Juan Regional Medical Center has no cardiologists, with hospital privileges, on staff. Many patients suffering from heart attacks in San Juan County are being flown to Albuquerque or taken by ambulance to Mercy Medical Center in Durango.
FARMINGTON —A departure of heart doctors in the past couple of months from San Juan County is leaving cardiac patients without options and San Juan Regional Medical Center scrambling for assistance.

"We have no cardiologists (with hospital privileges) on staff," the hospital's vice president of marketing Catherine Zaharko said Thursday.

Many patients suffering from heart attacks in San Juan County are being flown to Albuquerque or taken by ambulance to Mercy Medical Center in Durango, Colo., said David Bruzese, Mercy spokesman.

"In the last few weeks, we've begun to see three to four patients a week (from Farmington)," Bruzese said, adding some of those patients need "intervention care," such as the placement of stents, which are tubes that prop open blocked arteries.

Bruzese added that Mercy understands "more (patients) are going to Albuquerque."

San Juan Regional officials did not say how many heart patients are being sent to Albuquerque.

Zaharko said San Juan Regional is attempting to remedy the situation with active recruitment, adding while there are no cardiologists, "the medical staff is stepping up to the plate to coordinate care."

Emergency room doctors, hospitalists, radiologists and local physicians are offering their assistance, as are temporary contract physicians.

The local cardiologists left for a number of reasons, Zaharko said. One wanted to complete a two-year fellowship at Brown University, one left for personal reasons, and a third rescinded his hospital privileges.


A fourth cardiologist left the area because of a lack of specialized technology at the hospital.

Doctors wanting to use the hospital's facilities to care for their patients must be certified by the board of directors. Once certification is received, they have "hospital privileges." The process is lengthy and doctors must agree to care for their patients, as well as a number of "unassigned patients," said John Buffington, San Juan Regional's chief operating officer.

"There's a lot of obligations that go with that (hospital privileges)," he said.

Some doctors choose not to go through the process or did not pass the rigorous background checks and board approval. Farmington's two remaining cardiologists, John Lovejoy and Rami Khouzam, do not have hospital privileges, according to Zaharko.

San Juan Regional is not able to provide patients with intervention care. This is a specialized form of cardiology that includes the placement of stents and surgical implants such as defibrillators and pacemakers. Cardiology patients requiring this level of care have to travel to Albuquerque or Durango for services.

Bruzese confirmed that Mercy does offer intervention care as well as a state-of-the-art, 64-slice CT (computed tomography) scanner.

"This is a non-invasive tool for diagnosing coronary arterial blockages," he said. "It scans the entire heart in a second or two, and provides a brilliant three-dimensional image."

San Juan Regional recently ordered a 64-slice CT scanner, and it should arrive by mid-summer, Buffington said.

Farmington's hospital does have a cardiac catheterization lab, something Mercy plans to open in a few months.

The products that are not yet offered here, will be in the future, according to Zaharko.

"We have a strategy to expand the program to include both diagnostic and interventional cardiology," she said.

"Our plan is to actively recruit cardiologists to be a part of the hospital," Buffington added.

Updating the program could help in getting heart doctors here and retaining them. Mercy Medical Center has five cardiologists on staff and is not experiencing some of the issues Farmington is with recruitment and retention.

Bruzese said that could be because of Durango's high quality of life, as well as its modern hospital services.

Farmington also offers a high quality of life, and visiting physicians are impressed with San Juan Regional, Buffington said.

There, however, are problems with keeping physicians here.

Chuck Redwing, administrator of Orthopedic Associates, said the problems vary from a lack of private schools and shopping to an airport with unreliable service.

"Airport service kills us every time. Three hops is a tough, tough sell. We have lost more good candidates because of that than any other factor," Redwing said.

Mesa Airlines offers only one flight daily to and from Albuquerque, and there are "reliability problems" with the flight, said Rod Hunt, general services manager for the city of Farmington.

Hunt added there are "good connections" to Denver and Phoenix on US Airways and Great Lakes Aviation.

Other concerns from potential doctors are a lower pay rate than is offered by large practices and hospitals in metropolitan areas, Redwing said.

"The doctors we talk to are not driven by greed and money," he said.

He added doctors need a high salary to pay off student loans and support a family.

In some cases, San Juan Regional Medical Center will offer salary guarantees to doctors, Buffington said.

"When a physician joins a practice there is a lag time between seeing patients and insurance reimbursements," he said. The hospital will cover the doctor's pay during those times.

A lack of specialists in Farmington is not new, according to both Buffington and Redwing. A few years ago there were limited numbers of orthopedic surgeons and radiologists. There could by a shortage of obstetricians in the near future.

"This animal keeps floating around the medical community," Redwing said.

Debra Mayeux: