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US: Small-town doctor takes on corporate health-care giant

by Tony MessengerColumbia (MO) Daily Tribune
November 15th, 2005

Jeff Turk is a small-town boy.

Heís also a geek to the highest exponential power. The combination of traits has him at odds with his profession.

Turk is a doctor, a radiologist specifically. He calls himself a physicianís physician. Turk doesnít meet with patients as much as he does other doctors. He reads the scans and film and pictures that help other doctors diagnose and treat their patients. He surrounds himself in his specially equipped, ultra-air-conditioned office at Moberly Radiology and Imaging with eight high-tech computer screens that provide a look into his patientsí high-volume CT scans from every 3-D angle and color possible.

Only the best, latest and generally most expensive gadgets will do, Turk says. He developed that attitude while he grew up in Grafton, Iowa - population 249 - and saw how medicine too often shortchanged folks in rural America.

"Rural people donít always get the best medical care," Turk says. "Growing up, I didnít think that was right."

He brought that attitude with him to Moberly when he and his wife moved here. Turk chose Moberly because it was about halfway between Oklahoma City, where he had been practicing, and his family in Iowa. He checked out Columbia and other cities, but Randolph County, he says, is where he thought he could make a difference.

Now the hospital that brought him here - Moberly Regional Medical Center - is trying to run him out of town, he says.

Turk and his partners are caught in a battle over big bucks and local patients with the corporate owner of their local hospital, Community Health Systems, a multibillion-dollar Tennessee corporation. Although the fight probably has its roots in Turkís decision to open his radiology office in a building just west of the hospital at a time when the hospital didnít have similar capabilities, the latest battle is being fought over Turkís effort - with several other doctors and investors - to open a top-of-the-line surgical center in Moberly.

Turkís center, the Surgery Center of North Central Missouri, opened in August in its brand-new building off Highway 63. If Moberly Regional Medical Center has its way, it will be closed before it can turn a profit.

Why? Greed. Thatís what the doctors of Turkís group think anyway.

Theyíre caught in a game of medical warfare being played out similarly in courtrooms all over the nation. More and more, private doctors are combining resources to open small surgical centers to meet niche needs, control expenses and turn a profit. The corporate barons of large hospital systems, and even some of those who arenít for-profit systems, are standing in the way. In Turkís mind, the loser is the patient.

Thatís what he sees in Moberly, where a corporate hospital cuts costs and fights competition.

"There has been a definite pattern" at Moberly Regional "that has been: Minimize the amount of local investment, and maximize profits," Turk says. "Health care has suffered as a result."

As a result of Turkís battle with the hospital, his state-of-the-art facility sits mostly empty. His license doesnít allow doctors to perform surgery at the facility unless they have privileges at the local hospital. The hospital hasnít granted privileges to any doctors connected to the center who have applied.

Turk calls that a conspiracy, and his group sued Moberly Regional in federal court, alleging predatory business practices. He also sued the state over its requirement that the only hospital that can legally sign a patient transfer agreement - in case a patient needs an overnight stay - is the one in Moberly. Turk has such agreements in Mexico and Columbia. State law says thatís not good enough.

Turk lost his privileges at Moberly Regional in May. He blames Harold Siglar, the hospital administrator, for refusing to allow any doctors connected with the surgical center to also have hospital affiliations, the kinds of privileges regularly granted in communities to any doctor of good standing.

Siglar says thatís not true.

"Absolutely not," he says. Siglar says the "medical staff asked Dr. Turk to leave."

He says itís true that no doctors affiliated with the surgery center have been granted privileges, but he says thereís no conspiracy.

"This is America," the hospital administrator says. "This is the home of capitalism. Theyíre welcome to build whatever they want to build."

Siglar says he wonít sign a transfer agreement because he doesnít want out-of-town doctors serving patients at his hospital. He calls it a safety issue, wondering what would happen if an out-of-town doctor couldnít be reached on the telephone.

Apparently, the technology revolution hasnít reached Siglar. Nor has a concern for his community, Turk and his supporters allege.

"By not signing a transfer agreement, theyíre telling the community they donít care," anesthesiologist Bill Wall says.

For a small-town boy from Iowa, thatís not good enough. Turk knows heís fighting a battle against a corporation that has enough money to win. He knows he might end up fighting it alone as doctors move on to other opportunities. His surgery center is down to two doctors who can actually perform surgeries, and the legal battle is just beginning.

"Iím very idealistic, I know," Turk says. "Naive? Probably. Ö The easiest thing would have been to walk away, but thatís completely against what Iíve set out to do in my life. This is what happens when you have corporate health care in America."

Turk says heís in for the long haul: "Iíll personally go on for as long as it takes."

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