October 23, 2012 -- A Lincoln City physician’s abrupt transfer and firing highlights a statewide issue of unilateral authority that health plan administrators have when reassigning or laying off physicians.
Samaritan Health Services initially reassigned Dr. Robert Oksenholt, one of Lincoln City’s most popular and long-serving physicians, to Lebanon, which is more than a two-and-a-half-hour drive to the southeast.
In a July 18 letter sent to his patients, Samaritan said Okslenholt, known locally as “Dr. Bob,” would wrap up his Lincoln City practice August 17 and become a hospitalist and critical care specialist at Samaritan Lebanon Community Hospital.
That letter, written by Samaritan CEO Dr. Larry Mullins, said the move would allow Oksenholt to “fully utilize the specialized training he’s received in these areas for the benefit of a larger number of patients. This has long been an area of interest to Dr. Oksenholt and, while it is difficult for him to leave his position at Samaritan North Lincoln Hospital, it is made easier by the greater good he can accomplish for all involved.”
Oksenholt said he never intended to leave Lincoln City, and refused the offer. Instead, he informed Mullins that he planned to compete with Samaritan by opening his own practice, taking along his former patients. After arguing with Samaritan executives, the health plan fired him August 3.
To make ends meet until he can open his practice, Oksenholt has been working at a hospital intensive-care unit in New York, and traveling weekends to Lincoln City. At the new clinic, Oksenholt also intends to offer classes on yoga and Mediterranean cooking, according to his attorney Stephen Lovejoy.
“He has hundreds of patients here in Lincoln City that are basically left without a physician,” Lovejoy said. “He’s working on acquisition of property to open a clinic and to bring in outside medical providers with specialists.”
People who previously saw Oksenholt have been helped to find another physician, said Lincoln City Hospital CEO Marty Cahill. Dr. Dean Orton assisted in reassigning many of Oksenholt’s former patients, some of whom ended up transferring to his brother Dr. Erling Oksenholt.
Patients Take Sides
Before the decision was made to transfer Okensholt, Samaritan accused him of “not being a team player” saying he had made a significant number of outside referrals such as to Oregon Health & Science University when his patients needed specialty care, Lovejoy said.
Suzanne and Jim Derham, both 66-year-olds on Medicare, live a few miles south of Lincoln City and were upset after hearing that Oksenholt had been transferred.
They believe Samaritan is guilty of using anti-competitive practices by requiring their physicians to only refer patients to doctors inside their system.
“Samaritan has a monopoly on healthcare in Lincoln County, and Dr. Bob got fired because he sent people for specialty care,” Suzanne Derham told The Lund Report. “Bob’s ‘transfer,’ forced by Mullins, is an internal power play. He is answerable to no one apparently.”
The Derhams tried finding another primary care physician in their area, at Bayshore Family Medicine, but realized it doesn’t accept their insurance, Tri-Care. So they intend to cheer on Oksenholt when he opens his own clinic.
“Morally and ethically, doctors should offer their patients all treatment options and access to the physicians capable of that care,” Derham said. “He’s giving those folks at Samaritan a good run for their money.”
People living in Lincoln City have choices beyond Samaritan. Two other primary care clinics offer primary care, said Cahill. Oksenholt’s firing was due to “personnel issues,” he said, not because of outside referrals. Samaritan tracks referrals but lets physicians send their patients to specialists outside their system “as they see fit,” Cahill said, adding, “Human resources and personnel issues typically involve interpersonal relations and disruptive behavior.”
At this point, the Derhams “don’t know what to do” until Oksenholt opens his own clinic.
“Both my husband and myself are not well, and we cannot travel far,” she said. “My husband needs a double hernia repair and was just diagnosed with carpel tunnel. I was used for medical experimentation in 1973, which saved my life, but I need regular monitoring. This loss of our doctor is very stressful and upsetting needless to say.”