By Mary Alice Murphy

Cheryl Willman, MD, and director and chief executive officer of the University of New Mexico Comprehensive Cancer Center, and members of her staff were honored guests at the Gila Regional Medical Center open house on Oct. 19, 2017, to welcome the reopening of its Cancer Center. A UNM oncologist began seeing and assessing patients on Friday, Oct. 20, 2017.

A request for proposal process last year sought providers of cancer treatment to residents of Grant County and the surrounding region, after negotiations with the at-that-time provider had broken down. Gila Regional received two proposals.

After an evaluation process, members of the committee chose to go with the UNM Cancer Center instead of choosing the former 20+ year provider.

The process of replacing the former provider has brought great angst and stress to patients and caregivers alike, involving many in the community. Town halls were called for and mostly those against the change spoke and bombarded the hospital, which is county-owned, and the county commissioners with questions and rumors. A seeming dearth of facts prevailed, unless inspection of public records requests were made, and even then, interpretation of documents varied from "expert" to "expert."

The Beat had the chance to talk to Willman and get some questions answered.

The first question asked was why the transition had taken so long.

"From my perspective," Willman said, "this has been a rapid transition." She said the head of the former provider of services was a long-time friend and colleague.

The interview was interrupted by a knock at the door, with Dr. James Skee of Silver Health Care wanting to ask questions.

[Editor's Note: Many of these questions were on this reporter's mind, so as no one asked her to leave, she listened in and took notes.]

Willman told Skee that all of the doctors from the UNM Cancer Center are double board certified in hematoloty and oncology.

"We've hired a fabulous physician assistant to be in this facility," Willman said. Skee replied that the hospital had "stolen" the P.A. from his practice. Willman apologized but said she was happy to have such an excellent employee, in tough times of trying to recruit good caregivers.

"Part of the things we're trying to do is organize events for physicians and the community explaining our services," Willman said. She said Susie Trujillo, former GRMC employee, would organize the opportunities for dialogue.

Willman said when UNM was asked to provide services, "we said we wanted to make the practice self-sustaining and stable. We wanted a new update to state-of-the-art medical records installed using Mosaic." She confirmed that it interfaces with the recent upgrade by GRMC to MediTech 6.

"We will have real time access to medical records here and in Albuquerque," Willman said. "Until we complete the hiring process for a full-time oncologist to live here, UNM oncologists will rotate down here once a week. Our goal is to have care here seamless with our system in Albuquerque."

She said they were advertising nationwide for a full-time oncologist, with the goal of having the oncologist living in Silver City and providing services full time. "We plan to have a radiological oncologist bounce down here at least once a week, maybe more."

The plan is to build the practice at Gila Regional in three phases. "Phase 1 is to update the systems. Doing this transition in six months is amazing. I know it seems like a long time, but it's gone quickly."

"We want to build relationships here in the community," Willman continued. "The network we're trying to build has us at the hub."

She said, as part of Project ECHO, which links expert specialist teams at an academic hub with primary care clinicians in local communities, UNM hopes to be able to provide specialists to the local community.

"I serve on the Biden Cancer Foundation," Willman said. "It is not OK for a patient to have to drive to UNM or another city for care. We will use good IT (information technology) for web-based conferencing. We will need the patient to come to Albuquerque only for specialty surgery and then they will come back here for care."

She noted that the GRMC Board of Trustees would made the decision on how to share electronic medical records.

"Gila Regional owns everything," Willman said. "It's your staff, your records, your equipment. The Board will decide whether to accept TriCare for veterans."

Dr. Richard Lauer, one of the UNM oncologists, joined the conversation. "The hospital will own the Cancer Center, not us."

Willman said UNM Cancer Center has 130 medical oncologists. "We have the state's only brain cancer surgeon and the only surgeon for bone sarcoma."

She talked briefly about the federal 340B drug discount program, which requires drug manufacturers to provide outpatient drugs to eligible health care organizations, participating in Medicaid, and covered entities at significantly reduced prices.

She noted that participating hospitals must be community-owned and not-for-profit. If the hospital is sold or somehow changes its status, it could lose the 340B benefit.

The oncologist who will serve patients for the first two weeks until the regular rotating oncologist returns will be Dr. Amy Tarnower. The one who will regularly rotate to GRMC will be Dr. Ian Rabinowitz.

To continue the transition question, Willman said everything is complete. "We want everything to be patient-centered. We are helping Gila Regional with the IT requirements. We have trained the physician assistant. We will bring down the radiation oncologist as soon as the recommissioning of the nuclear medicine machine is complete."

"Even though we didn't have doctors here, we have had a lot of UNM people here for four months," Willman said. "They were doing an intense amount of insurance, finance, medical IT and electronic records work."

Lauer said people went to UNM for training.

Willman said that, although the previous provider Dr. Barbara McAneny, had run the facility with one oncologist once a week and one radiation tech once a week, "We want a medical oncologist here every day. We will start one day a week, with three physicians on call, until we have the full-time one. Our doctors see 20-30 patients a day. There is a national shortage of medical oncologists."

Lauer added some explanation on the 340B program. "It's a Health and Human Services program, instituted by federal law. It was developed for the underserved poor in rural areas."

"Our hospital is owned by Bernalillo County," Lauer said about the UNM Cancer Center. "We can apply for the 340B pharmaceutical program to get drugs at discounts of 30 percent or 40 percent. Everyone who comes in the door, who has little to no insurance, is eligible. The drug companies don't like it. It has been abused by for-profit hospitals, but it does fulfill a purpose. It allows Gila Regional to function. The hospital charges are rare. And what a hospital charges is meaningless. It's what is paid."

Willman and Lauer joined the crowd gathered for the open house. The Gila Regional cafeteria presented the finger food, which ranged from crab sashimi to mini-fajitas to meatballs in marinara sauce, from chips and salsa to mini-vegetable trays, and three mini-desserts to choose from, two with chocolate and one vanilla-flavored.

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