Accountable Care In the News What to Watch

St. Luke’s, Saltzer Medical Group, and the Value of Relationships

You may have seen an ad by the Saltzer Medical Group this weekend in the local papers. If you missed it, here it is: Expect More From Medicine

There is a tremendous amount of misinformation being circulated about the integration of Saltzer Medical Group and St. Luke’s, and there is no better party to set the record straight on some of these issues than the Saltzer Medical Group physicians who personally signed the ad. The Saltzer Medical Group is an outstanding group of physicians with whom St. Luke’s has been proud to be affiliated with for a number of years, and I am proud that they are standing up and making themselves heard. St. Luke’s did not contribute to the development or the cost of this ad.

I would like to make several points:

  • For more than 100 years, St. Luke’s has been serving patients throughout the region, regardless of ability to pay. We remain Idaho’s only locally-governed health care system and we remain committed to acting only in the best interests of the patients we serve.
  • St. Luke’s presence and service in Nampa, where historically there has only been one hospital, give patients a choice of hospital providers. Arguments to the contrary defy common sense and would appear self-serving.
  • St. Luke’s employs and contracts with physicians whose practices are based in a number of communities where St. Luke’s does not have hospitals. We have always been committed to those physicians practicing at and supporting those local hospitals, including Saint Alphonsus hospitals.
  • St. Luke’s does not impose itself on physicians. It would never occur to us to file a lawsuit to prevent an independent physician or physician group from working for any organization they wish. We also don’t feel that any physician, including one that is employed or contracted, owes us their referral. We work to earn the trust and confidence of physicians every day. If they refer patients to us, we appreciate that. My wife was referred to a Saint Alphonsus physician because of a particular problem she had. We received excellent care, and it was the proper thing for her physician to do.
  • Our discussions with Saltzer physicians have always accounted for and encouraged those physicians to continue their practice at Saint Alphonsus’ Nampa hospital. While Saint Al’s continues to allege that a St. Luke’s integration with Saltzer will result in decreased admissions to their Nampa hospital, an allegation that we strongly disagree with and will refute, it seems Saint Al’s leadership fails to recognize that their own actions and statements have done more to harm physician relationships and referrals than anything St. Luke’s would ever do.
  • For more of Saltzer Medical Group’s perspective, here is a link to a “Reader’s View” piece written by Dr. John Kaiser, Saltzer president.

St. Luke’s vision is to transform health care by aligning with physicians and other providers to deliver integrated, seamless, and patient-centered quality care across all St. Luke’s settings. Our strategy is to create a clinically integrated network of physicians that will work together to manage the health of populations, hopefully avoiding the need for hospitalization through better care in a more coordinated manner, greater value to the patients, and lower costs for our communities. Productive, respectful relationships with physicians are critical for us to achieve our vision.

It is about relationships. It is about physicians being able to work with and refer their patients wherever they wish. And it is about transforming health care, not generating more hospital admissions. We will not get health care costs down by continuing to focus on additional hospital admissions. We have to achieve the Triple Aim of better health, better care, and lower costs. The people of Idaho are counting on us to do this for them and with them. I want to get on with the transformation, and I believe you do as well.


  • David,
    Thank you for this communication and the letter sent out last week to entity Board and Committee members. It is imperative that we have accurate and up-to-date information to effectively represent St. Luke’s position in our communities.
    Tom Ashenbrener

  • Hi, Tom.

    You are most welcome. We are always looking for more and better ways to communicate. Thanks for your service to our System, and thanks for following the blog!

  • Hi, Hongmey.

    I really appreciate you taking the time to write in to support and encourage our efforts to transform health care, to improve the health of the people in our region, and to be transparent about what we are doing and why! Thanks so much, and thanks for following the blog!

  • Dr. Pate,
    Several of the doctors who work for Saltzer are not board-certified. Will they be required to attain board certification in order to practice with a St. Luke’s facility?

  • Hi, Marilyn.

    Great question. That is up to the individual physicians. We have, from the beginning of our discussions, encouraged Saltzer physicians to keep their privileges at Saint Al’s Nampa and to continue to provide their patients with choice.

    A lot of the patients Saltzer Medical Group physicians treat are Saint Al’s employees who will need to be able to have their care at Saint Al’s. On the other hand, many of their patients ask to come to us for their care.

    However, recent actions have alienated many of these physicians. The way Saltzer leaders have been treated, recruitment tactics which have resulted in financial hardship for the group, misstatements made in public media about the group, and the lawsuit to stop Saltzer from affiliating with the organization that they have chosen appear to have done great harm to their physician relationships. At the end of the day, Saint Al’s leadership must look in the mirror, instead of to the courts.

    Thanks for your question and thanks for following the blog!

  • I thought I would share with you a quick experience I had with a patient yesterday when I called to pre-register them. The patient was immediately on the defense before I could even finish my introduction, then lectured me about how our competitors have merit in their case against SLHS and that we are trying to dominate the market.

    I told them that while I understand that it may look that way to the general public, I informed them that Saint Alphonsus has chosen to remain publicly quiet on some facts of their own. I encouraged the patient to do further research, and told the patient that not only do you, Dr. Pate, hold a legal degree, you have a team of legal experts to help with the lawsuit, and that if there are legal problems, they will be dealt with properly. The patient almost immediately dropped the subject and let me do my job.

    The general public is unfortunately only given what the media tells them, and the media typically does not have all the details, or accurate ones, and so people misinterpret them.

    In school, I learned that the Boise Treasure Valley area is considered rural, and not city. If we were as big as, let’s say, New York City or L.A., I really don’t think a similar situation would be tangled up in the legal system.

  • Hi, Barbara.

    I am so sorry that you had to experience this. We would very much like for people to reserve judgment until all the facts are out, but those making the allegations have worked very hard to make sure that only their side is presented. We strongly disagree with many of the public statements they have made.

    Saint Alphonsus has spent a lot of money using a PR firm and advertising to go on the attack to try to win public sentiment and to present St. Luke’s and the Saltzer physicians in a false light. I very much regret that they have done so. I don’t think we should be causing people to lose confidence or trust in their health care providers. I don’t want this to hurt their reputation or cause embarrassment to Saint Al’s fine employees. I really hope that it does not come to that, but the cat is already out of the bag.

    You are quite right that Saint Al’s has not been forthcoming with all relevant facts, and specifically those that will not serve them well and don’t support the public positions they are taking. That is the one good thing about going through this expensive fight: The facts will come out and the public will have the chance to see, if Saint Al’s and the Treasure Valley Hospital continue with the lawsuit to trial.

    It sounds like you handled this extremely well. You and our other employees make me so proud, how you keep the patients in mind first and continue to do your jobs professionally. You, like me, are unwaivering in a commitment to improve the health of the people we serve.

    Thanks so much for all you do for St. Luke’s and our patients, and thanks for following the blog!

  • Hi, Greg.

    Thanks for your question. Not all hospitals in the Treasure Valley require board certification, but we do.

    Since the clinic would be a hospital outpatient department, the physicians would have to satisfy the credentialing criteria for our medical staff. That criteria requires board certification within a certain amount of time. Some of these physicians did have board certification and let it lapse, since it was not previously required. They are all in the process of recertifying. A few never sought board certification, but are now.

    Thanks for your question and for following the blog.

Leave a Comment