For surgeon, lessons in her hospital's closing

Surgeon Beth DuPree's bricks-and-mortar dream - a specialized hospital for breast-cancer patients - closed Wednesday, a victim, she says, of the economy and naive business planning. But her hope remains intact.

For her, the closing of the Comprehensive Breast Care Institute at DSI of Bucks County, a freestanding, for-profit hospital in Bensalem, is both cautionary tale and learning experience.

"Although the business model failed, the patient-care model succeeded," she said this week from her home, where she is recovering from surgery to correct a painful colon problem.

The 24-bed hospital opened in April 2007 with hopes that its approach to care, which was heavy on coordination, emotional support and creature comforts, would draw patients from far and wide. But Diversified Specialty Institutes, the Nashville company that operated the hospital, pulled the plug, saying patient volume was too low and credit too elusive to keep it open.

DuPree, a general surgeon who specializes in breast-cancer care, was chief executive officer and medical director - and an investor as well.

When the hospital opened, competitors wondered whether it was needed in a region flush with cancer programs. But DuPree said she was offering a place where breast care and patients' emotional needs would be a priority, something they would not find at neighboring hospitals or the big cancer centers.

Since then, DuPree, 47, has had one of those years that can make middle age such a trial. Both her parents had serious illnesses. She had her own physical problems. And her business was in trouble.

She concedes she has done some crying, but remains remarkably upbeat. Like most of the doctors she worked with at DSI, she has privileges at St. Mary Medical Center and Holy Redeemer Hospital and Medical Center. She said she thought patients would follow the doctors and said the hospitals were open to change. They already have improved care coordination, she said.

In retrospect, DuPree said she thought she should have studied more before undertaking the hospital deal. "I wouldn't blindly trust someone with a business plan I didn't completely understand," she said.

For example, she said she thought DSI, which mostly runs dialysis centers, underestimated the competitiveness of the Philadelphia market and the importance of making deals with health insurance companies here. DSI operated out of network, which meant that some potential patients were not covered for treatment there and could not afford to use the hospital.

Also, while company leaders were trying to negotiate good deals on radiation equipment, the hospital went more than a year without the ability to give radiation treatments. "It was one of the profit centers we needed to have going," she said.

DuPree said she still thinks it is a good idea to give patients private rooms, comfortable beds and pretty gowns. She said hospitals should make it easy - as she did - for spouses to sleep over. She said her patients got good care and hoped she would now be able to use more of her ideas in the traditional hospital setting.

"It's not like I failed. If the business model had been a success and the place was making money hand over fist and the investors were making money and the patients were getting [bad] care - that would have been a failure," she said. "I'd rather win on the patient side and fail on the business side any day of the week."