WE URGE ST. FRANCIS TO RECONSIDER OFFICE BUILDING

The debate over medical competition has been around since the establishment of two hospitals in Cape Girardeau. But as medical costs have continued to rise, disputes over duplicated services have heated up.

At the center of the recent controversy is St. Francis Medical Center's plans to construct a doctors' office building on its campus.

After months of informal discussions and community objections, Administrator John Fidler announced plans to build a "one stop" facility, which combines doctors' offices with medical laboratories and technologies.

We urge St. Francis to seriously reconsider this proposal.

Many community groups and individuals are simply not behind this project. Most outspoken has been the Southeast Missouri Business Group on Health, which questions the need for doctors' offices on hospital campuses when space exists in town. Southeast Missouri Hospital officials have indicated that if St. Francis builds such a structure, they will be forced to follow suit.

St. Francis countered objections with a good defense. Officials pointed out that Southeast Missouri Hospital's new addition represented "a costly over construction program."

To that we say, St. Francis leaders are simply missing the point.

Neither this newspaper -- nor the community at large -- are balking at the concept of new construction at St. Francis. We are proud of the fact both hospitals offer state-of-the-art technology and services. We would embrace most any building project at St. Francis with the same enthusiasm as we did Southeast's recent expansion. For the most part, both not-for-profit hospitals have been good stewards of the public trust and dollars.

But we draw the line at flagrant duplications of medical services.

We would make the same battle cry if Southeast had been the one to first announce plans for a doctors' office building. And we will do so if Southeast counters with a similar proposal.

Cape Girardeau can ill afford the kind of competition and senseless duplication of services that turned Poplar Bluff into an overpriced medical center. Hospital services there are some of the highest in the region.

We have to wonder if the state really has the wherewithal to adequately judge the "need" for local medical services or the ability to prevent duplication. It seems Certificates of Need required by the state have little impact -- even if groups protest.

This project goes beyond mere competition between hospitals. It stretches out into the business community. There's little doubt offices at one or both hospitals would draw doctors from other commercial properties in town. One might wonder about the equity of a not-for-profit agency competing head to head for office space with for-profit groups.

Numerous local doctors have also worried that hospital office buildings would be divisive -- aligning physicians with one hospital or another.

St. Francis claims this proposal is more than a building, calling it a cost effective way to deliver health care because testing and doctor visits could be done at one location. What they fail to mention is that the services are already here. The hospital's plan would unquestionably come at the detriment of existing operations.

We are not convinced that larger consolidated units of doctors and services are the answer to tomorrow's health care. Is this the cheapest form of health care now? Sometimes ... sometimes not.

Instead, the answer lies in working together for health care solutions. And that's why we implore St. Francis not to proceed with this project as it now stands. An alternative might be a one-stop shop for hospital-based services and technology without doctors' offices.

Hospital boards must do more than pay lip service to the notion of cooperation. If St. Francis moves ahead with this concept, it will seriously sabotage future collaboration efforts in the eyes of the public. An erosion of community faith seems a heavy price to pay for this office building.