St. John's Mercy Hospital and Patients First are separating or at least the cardiologists have been kicked out of the relationship. The custody battle will be with the citizens of Washington in having to choose between the hospital and their doctor. Who's at fault? Depends on who you listen to, just like in a divorce each is blaming each other and we the children will never know the full truth. So what do we know?

The decision to end the hospital privileges of the cardiology group, according to the paper, was made not in our own hospital but by the powers in St. Louis. Should decisions concerning our local community be made by a board that does not live here? Do the Mercy cardiologists even live in this area? Do they call Washington home? How quickly could they get to the hospital in an emergency? I did a people search on the Internet and could find neither name, living in the Washington area.

Patients First is not an innocent bystander. Its complex does provide competition to the hospital in areas that are financially profitable. But we as the consumer have a choice between using the outpatient services at Patients First or the hospital. Part of the decision is usually made for convenience and the other is where our insurance will pay for it. The Patients First doctors do live in this community, send their children to our schools and pay taxes to our community. Some of the physicians grew up here and have come home to practice.

So what does this decision really mean? If you are a Patients First cardiology patient, and you need emergency cardiac care, you can still go to the hospital and be treated by your personal attending physician, but not your cardiologist. If you require a higher level of cardiac care you will be transferred to another hospital just like it is now and always has been. If you are a Mercy cardiology patient and need emergency care you go to the hospital. If you need a higher level of cardiac care you will be transferred. The difference is the continuity of care and the relationship that has been built between you and your Patients First cardiologist. That could mean a life-threatening difference if you are elderly, or any age, and cannot remember all of your health history.

Our biggest concern should be, is this going to be the only practice that the hospital is going to target? What is to say that the St. Louis powers force us to make more decisions in the future concerning other Patients First physicians, or it could be any physician who admits to the hospital? They could just as easily stop other physician groups from admitting to the hospital and bring out "their" groups. This does not sound like a "community hospital."

As a matter of record, I am a patient of the Patients First family practice and have been so since the original three physicians came to town, but have also sought out care by non-Patients First physicians. I have also been a patient in both St. John's Mercy Medical Center and St. John's Mercy Hospital.