Physician-hospital competition: NC physicians fight regulatory board

Physician groups looking to expand their outpatient operating facilities are coming up against perceived unfair business competition over certificate of need applications before the North Carolina State Health Coordinating Council.

Karl Stein, MD, administrator of the Raleigh Orthopedic Clinic, says the state rejected the application of his practice group to open an operating room in 2006. In the same year, the state approved an expansion to Apex Day Surgery Center, an outpatient clinic operated by the WakeMed health system, according to a Feb. 19 report in the Triangle Business Journal.

A certificate of need granted by the state of North Carolina is required for constructing outpatient operating rooms. 

"I have no idea how they pulled that off," Stein told the newspaper. "This is an example of how the game gets played that irritated a lot of people."

The North Carolina Hospital Association and physician groups both have interests at stake as the state considers reforms to its 2008 State Medical Facilities Plan.

As physicians allege unfair competitive disadvantage to the state, hospitals reply that physician competition for operating facilities often forces hospitals to close certain specialty lines.

"We try to be as fair as we possibly can," said Lee Hoffman, chief of the certificate of need division of the state's health regulatory department, the paper reported. "Just for the record, there is no outside political intervention in any of the certificate of need findings."

Source: "State to reexamine certificate of need process as doctors complain," Triangle Business Journal, February 19, 2007.