Capsules

Six Former US Surgeons General Call for RFK Jr. Ouster

In a recent Washington Post op-ed, the six surgeons general appointed since George H.W. Bush’s presidency have called for the removal of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.

“We are compelled to speak with one voice to say that the actions of Health and Human Services Secretary Robert F. Kennedy Jr. are endangering the health of the nation,” they wrote. “Never before have we issued a joint public warning like this. But the profound, immediate and unprecedented threat that Kennedy’s policies and positions pose to the nation’s health cannot be ignored.”

Speaking out were Jerome Adams, MD; Richard Carmona, MD, MPH; Joycelyn Elders, MD; Vivek Murthy, MD; Antonia Novello, MD, MPH; and David Satcher, MD, PhD, who noted that Kennedy has created a crisis in the nation’s public health system and health agencies, which is resulting in mass resignations, short staffing, a resurgence of infectious diseases and worsening chronic illnesses. They wrote, “Secretary Kennedy is entitled to his views. But he is not entitled to put people’s health at risk. He has rejected science, misled the public and compromised the health of Americans.”

Other groups of medical professionals are joining this movement for ouster, including the Southern California Psychiatric Society (SCPS) and the Committee to Protect Public Mental Health. Each issued recent statements noting that Kennedy spouts dangerous ideas, including the idea of putting homeless people on “wellness farms” and saying common antidepressants are more addictive than heroin. In urging nationwide public and political support for his removal they cite his disregard for science that threatens not only the integrity of our health system but also the lives and civil rights of millions of Americans who rely on effective, evidence-based treatment for psychiatric illness.



The SCPS stated that Kennedy misrepresented psychotropic medications in the Make America Healthy Again report, claiming, “The report uses inaccurate statements as a basis for taking action to restrict access to critical services that ease suffering, restore functioning and prevent suicide. Without these critical services, criminalization and expanded use of civil commitment will curtail the ability of individuals with mental illness to lead productive lives.”

Colon and Rectal Surgery Associates Joins Minnesota Oncology

In a recent public address, Minnesota Oncology (MNO), a premier provider of cancer care services, announced that Colon and Rectal Surgery Associates Ltd. (CRSAL) has joined the practice. Offering state-of-the art colon and rectal surgery services since 1963, CRSAL will retain its name. For branding purposes, however, it will henceforward include that it is a division of Minnesota Oncology. This move unites the clinical strengths of two leading specialty care provider groups, expanding and elevating innovative, high-tech gastrointestinal and cancer care in convenient, patient-centered community locations.

“As Minnesota Oncology celebrates its 30th anniversary, this strategic step marks the next chapter in our evolution to ensure continued clinical excellence. CRSAL, like MNO, is known for its deep roots in the community and its unwavering dedication to quality care, said Paul Thurmes, MD, practice president, Minnesota Oncology. “At the heart of both organizations is a shared belief ­­— patients come first. From our providers to all our clinical and support teams, we are united in our dedication to improving lives and delivering compassionate, expert care at every touchpoint. We’re incredibly proud of what we’ve built, and even more excited about what we’ll achieve together. We look forward to this next chapter with confidence and enthusiasm.”

“We’re excited to join Minnesota Oncology,” said Aneel Damle, MD, MS, MBA, president/CEO, CRSAL. “Our formal collaboration continues a long-standing shared vision of providing leading-edge community-based care.”

MNO is an independent, community-based cancer care practice providing patient-centered, evidence-based treatment in the Twin Cities metro area. As the Twin Cities’ largest and most experienced cancer care provider, Minnesota Oncology offers patients access to more than 100 cancer care experts, personalized treatment plans, clinical trials and comprehensive services to support the whole person. The CRSAL care team includes 17 surgeons operating in four locations with an additional two locations specializing in pelvic floor care. It offers a world-renowned fellowship with 100 global applicants applying annually for five positions. Both practices are leaders in the development of medical advances. Together with CRSAL, MNO will continue to set a new standard of care by offering compassionate, clinically excellent treatment, backed by research and leading-edge technology.

Avera Celebrates 25th Anniversary

Avera, a Sioux Falls, South Dakota-based non-profit, recently celebrated its 25th year as a health system. A quiet giant serving five states in the Upper Midwest, including Minnesota, the Avera footprint covers 72,000 square miles and serves a population of over a million individuals. The extensive range of care includes multiple hospitals, clinics, senior living facilities, home care, pharmacies, health insurance plans and more.

The Avera brand became official in September of 2000 through an agreement between faith-based health care entities with roots reaching back over 125 years. Members of the Benedictine Sisters and Presentation Sisters arrived from Europe to the Dakota Territory in the 1880s on a missionary journey of education and then health care, responding to needs including diphtheria and influenza epidemics. Early hospitals founded by the sisters included Sacred Heart Hospital in Yankton in 1897, St. Luke’s Hospital in Aberdeen in 1901, St. Joseph Hospital (later Queen of Peace) in Mitchell in 1906, and McKennan Hospital in Sioux Falls in 1911. The Benedictine and Presentation sisters each founded systems of hospitals and nursing homes. In the late 1990s, they began considering how their systems could come together for the benefit of all, resulting in a unique co-sponsorship model. Avera began as a collaboration of 127 locations in 46 communities. Today, Avera employs 22,600 individuals at 315 locations in 100 communities.

“Like the courage of the Sisters who arrived in Dakota Territory in the 1880s, the Sisters were very courageous at the time of the formation of Avera, willing to lay aside any differences for the greater good as they trusted in God’s leading,” said James Dover, FACHE, president and CEO of Avera Health.

While devoted to their Catholic faith, the sisters recognized that Avera was composed of people from many faith backgrounds. So they made it a central point that Avera is “rooted in the Gospel,” living by Gospel values of compassion, hospitality and stewardship. “The mission to make a positive impact in the lives of persons and communities is one everyone can have ownership of,” Dover said.

Cloquet Clinic Announces Expansion

Essentia Health recently announced that construction would begin this fall on a project to double the size of its clinic in Cloquet, Minnesota. Since opening just three years ago, the clinic found rapid community acceptance and was so quickly and widely used that it has already outgrown the space in its 7,500-square-foot new construction building. Through providing timely on-site personalized care that includes imaging and radiology services and cardiology care, as well as urgent care that is open seven days a week, patient demand has created expanded needs. Additional services already available at the Cloquet Clinic include:

• General Surgery
• Gynecology
• Mammography
• Midwifery
• Obstetrics
• Neurology
• Orthopedic and Sports Medicine
• Pain Medicine

“Essentia is committed to meeting the growing health care needs of the Cloquet community,” said Sam Barney, administrator for Essentia Health. “We will be expanding family medicine and specialty care. By doubling the size of our clinic, we’re filling vital gaps in care and ensuring greater access to high-quality, compassionate health care for the patients who entrust us with their health and well-being.”

When complete, the expanded 15,000-square-foot clinic will add 16 exam rooms and dramatically increase access to family medicine and specialty services. With plans to hire additional providers and increase specialty outreach, the new facility will improve access to expert care for the community. Additional expansion elements include adding a retail pharmacy, which will offer drive-through access, as well as expanded patient parking. The project will take about a year to complete, and the clinic will stay open during construction.

Duluth Physicians Facing Contract Law Violations

The Minnesota Attorney General’s office recently issued a subpoena regarding the potential violation of a 2023 Minnesota law banning noncompete contracts. Wisconsin-based Aspirus, a health system operating 19 hospitals and over 100 outpatient clinics across Wisconsin, Michigan and Minnesota, is allegedly forcing doctors in Duluth to sign a heavily amended contract or resign. The contract includes a noncompete clause, which bars physicians from working at a competing hospital after leaving. An author of Minnesota’s 2023 ban on noncompete agreements says the contract likely violates the law, though labor law experts say it’s unclear how a court might rule. Two Aspirus physicians spoke anonymously because they weren’t authorized to speak to the media and fear retaliation for questioning their proposed new contracts. They noted significant changes to sections on compensation, physician’s duties and termination.

Several physicians were told that failure to sign would be taken as a resignation. “I wouldn’t have signed this if I was looking for a job,” said one physician. She described the amended contract as “very physician-unfriendly and very administration-friendly.” The administration has new power to change work hours and location and how many patients doctors see. Some physicians are seeing significant pay cuts as part of the process, said another physician. Rep. Emma Greenman, DFL-Minneapolis, who co-authored the 2023 legislation, said that she couldn’t think of a way that the Duluth hospital’s noncompete “could be enforceable and legal.”

One of the doctors expressed concern for their patients. “There’s not enough doctors here to take care of everybody that needs care,” said the physician. “But again, I’m also not sure I want to sign this.” The effect of banning noncompetes, the physician said, should be that “providers at least have some freedom to quit a lousy job, stay in the community where they live and keep providing care.”

Minnesota-based physicians are also “upset that they’re going to be shackled to the noncompete,” despite the 2023 state law banning them in new agreements, said the second physician. The contract amendments retained an existing noncompete from the physicians’ previous contract, which was renewed on a yearly basis — and thus also is arguably unenforceable because a renewed contract is considered a new agreement, employment lawyers say. The investigation is in its preliminary stages.

Government Shutdown Harms Disability Health Care

With the federal government shutdown now extending beyond two weeks, the Minnesota Association of Professional Employees (MAPE) recently issued a terse assessment. Shutdown effects are being felt nationwide and it is very possible they will continue beyond the 35-day shutdown during Trump’s first term. There are 18,000 federal employees working in Minnesota who are facing furloughs, layoffs, work without pay and threats of being fired. More than 100 workers in the Disability Determination Services (DDS) are deemed “essential,” and the State of Minnesota has guaranteed payment of their salaries through Oct. 27. In all previous shutdowns, Minnesota Management and Budget (MMB) has guaranteed DDS’ paychecks throughout the shutdown and was later reimbursed by the federal government as the law requires. DDS workers review and approve disability applications for the Social Security Administration.  

Currently, 9,300 Minnesotans are awaiting disability determinations, and nearly 6,000 more are waiting for their claims to be assigned to adjudicators. Lisa Becker, a disability specialist, said even a temporary furlough would be devastating for her clients, “Even though my colleagues and I will be suffering the uncertainties of the government shutdown, our clients will be suffering even more because their disability decisions will be delayed even longer by weeks or months.”  

“People call you crying, and worried about what’s going on in their life. They say no one cares about them. The system has left them behind,” said Melissa Green, disability program adjudicator, who reviews disability status claims for DDS. Like many of their colleagues, both Becker and Green are trying to support their families, and the situation will become more difficult if the shutdown continues longer than the Oct. 27 date the State has agreed to temporarily cover their salaries. Green, who has a young daughter with special needs, said, “I don’t know how we would afford to keep her in treatment to continue the process of getting her evaluated and getting her the care that she needs.” 

The federal government shutdown is now forcing the Minnesota Department of Health (MDH) to begin leveraging contingency plans as their employees are at risk of layoffs and services are at risk of disruption.