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Big health merger, big questions

On January 3, Broadway Medical Center in Alexandria opened its doors as Sanford Health Broadway Clinic. Sanford Health is the largest, not-for-profit health care system in the nation.

The new year begins with a new health care system in Alexandria and lots of questions on how it will work.

On January 3, Broadway Medical Center and Sanford Health officially merged to become Sanford Health Broadway Clinic.

Sanford Health, based in the Dakotas, has grown to become the largest, rural not-for-profit health care system in the nation with locations in 112 communities in seven states. The majority of Sanford's properties are part of a crescent-shaped swath from Sioux Falls, South Dakota, up through west-central Minnesota, into the Fargo area and east into Bemidji.

"We look forward to working together. Our focus is on enhancing access to medical services for people in the Alexandria area," said Dr. Bruce Pitts, Sanford Health chief medical officer for the Fargo Region.

Rick Geisel, president of Sanford Health Network's Fargo Region, said, "We only go to communities we're invited to. When we get a call from a community, we have an obligation to answer the knock at the door."

The initial merger discussions with Sanford were reportedly sparked by a long-time friendship between Broadway Medical Center's president, Dr. Douglas Griffin, and one of Sanford's presidents - the two have been friends for about 20 years, since they went to medical school together.

"Actually, this relationship was 20 years in the works," said Daniel Jones, administrator of Sanford Health Broadway Clinic.

Merger talks with Sanford Health started in April of 2011 and just seven months later, the deal was finalized.

Broadway Medical Center operated independently in Alexandria for 15 years before the acquisition.

Jones said mergers and acquisitions are occurring more often in the health care industry.

"They seem to have become the norm," he said. "Health care is a complex business and requires a lot of resources in terms of human capital, financial capital and technology; you need all of those things to provide the optimum level of health care to patients."


The new, bright blue Sanford Health Broadway Clinic signage is in place along Broadway Street and just a few days into the new year, Sanford Health Broadway Clinic Administrator Daniel Jones said there haven't been any large-scale sweeping changes internally.

"We're the same people - physicians and practitioners - doing the same job serving the same people," he said. "Things are going extremely well. We've been meshed into their organization very well."

Over the last 12 years, Jones said Broadway Medical Center has tripled in size and the merger with Sanford was the next step in the organization's evolution.

"We've been growing so much that [merging with Sanford is] very natural," Jones said.

There are already plans to expand local service offerings.

Jones said there are four new specialists joining Sanford Health Broadway Clinic's staff this year, including: a psychologist, allergist, pulmonary specialist and a pediatrician.

All but the outreach allergy specialist will reportedly live and work in the Alexandria community.

"One of the things we found most impressive with Sanford when they merged with MeritCare in Fargo about two and a half years ago - [Sanford Health] made all the rural clinics a promise that they would only add [services], not take away. We found they held true to that promise at all their rural clinics. We were very impressed by that," Jones said.


One of the central cogs in local health care is Douglas County Hospital - one of few county-run hospitals in the state.

Since word hit the street about the Sanford Health-Broadway Medical Center acquisition, there has been an air of suspicion in the local medical community about Sanford Health and the organization's intentions.

Sanford Health representatives attended the December 30 Douglas County Hospital board meeting and provided an overview of their organization, answered questions and attempted to quash rumors.

Pitts, Geisel, Griffin, Jeff Sandene, chief operating officer of Sanford Health Fargo Region; and Dr. Bruce Evink attended representing Sanford Health.

There were several worries expressed during the meeting, but Douglas County Hospital Administrator Carl Vaagenes summed up the board's core concerns: "The bottom line concern that we have is that there will never be an aligned economic and clinical incentive in the new relationship with Sanford, because Sanford and Broadway are looking out for the interest of their parent - Sanford - not Douglas County Hospital. So when we look to the future and decisions are made, [their decisions] will be made first and foremost in the best interest of [Sanford Health]."

Vaagenes also expressed concern about Sanford Health Broadway Clinic possibly duplicating services already offered in Alexandria.

When asked if Sanford Health would bring in competing services, Jones told the Echo Press, "That's not our plan. We only want to add [services]."

Hospital board member David Kjos told the Sanford Health representatives, "We've got doctors here in town that are part of our community and contribute to non-profits, and they're involved in the community. There's some fear here of not maintaining that or not growing that."

Fellow hospital board member Karl Bloomquist added, "In a small town that's what we're so concerned about - people living here, supporting our schools, supporting our tax base, spending their money here."

Pitts replied, "Let our track record speak for itself. Our intention here is to earn your trust and to cooperate with Douglas County to provide services to people in this region... at the present time, building trust is our goal."

As the hospital board meeting ended, Vaagenes told the Sanford representatives, "Your comments about trust are right on. This is new territory for all of us."


The most prevalent rumor and question floating in the community about Sanford Health's arrival in Alexandria is: Will patients seen at Sanford Health Broadway Clinic be sent to Fargo, or other Sanford Health facilities only, for follow-up appointments or specialty appointments?

"That is not the case," Jones said. "The goal of Sanford is quality care close to home."

Pitts added, "One of the cardinal rules, as long as I've been part of [Sanford Health], is that we do not tell doctors where to refer their patients. Period. If doctors [elsewhere] want to receive referrals and patients from Alexandria, they have to earn it. If patients have preferences to go elsewhere, we respect that entirely. The only way we're going to be able to build services here and keep more services close to home is to earn the trust of patients and physicians here."

Jones said he's heard the rumors and understands the community's concerns.

"I think there's a definite 'big WalMart's coming to town' feel. Alexandria has never had a big name in health care in town before. People are wondering what does this mean? How is it going to change the town? We're hoping it will simply add to the community, add greater resources to help grow the town all the more."

Vaagenes said the arrival of Sanford to the area is the "new normal."

"[The arrival of Sanford] is not a setback at this point because it's done. It's a new normal. Sanford will be here now and we need to work with them and they with us like we have in the past with Broadway Medical Center."

On Thursday, Pitts told the Echo Press, "Sanford has locations in 112 communities in seven states; several are similar to Alexandria, including Bemidji, Perham and Jamestown, [North Dakota]. Healthcare is a very dynamic industry and every community is different, but Sanford's guiding principle is to always do what is best for patients. Ensuring people have the best health care possible, no matter where they live, is at the core of our mission. In Alexandria our focus is on enhancing the care already available. We look forward to working together with the local community to do that."

About Sanford Health

• Largest, rural not-for-profit health care system in the nation.

• Headquarters in Sioux Falls, South Dakota and Fargo, North Dakota.

• Largest employer in North and South Dakota.

• 34 hospitals, 116 clinic locations, 31 long-term care facilities, 20,000 employees, 900+ physicians offering expertise in more than 70 specialties.

Follow Amy Chaffins on Twitter at @TheOsakisReview.

Amy Chaffins

Amy Chaffins is a journalist working for the Echo Press newspaper in Alexandria, Minnesota.

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