HCA Profit-Driven Goals Come to Asheville Community Health Care

Dr. Virgil Thrash
| Guest Opinion

My first memories of medical care and doctors were when I was 5 years old and had my tonsils removed in 1950 by our family doctor, Dr. Eugene Herman, in LaGrange, Georgia, a small textile town of 25,000 people.

Dr. Herman was a little scary. The nurses in our small hospital were kind and there was plenty of ice for my sore throat. In my early teens, Dr. Charles Cowart, a local surgeon and family friend, though always busy, was never too busy not to ask about my fox terrier, Butch. Those early memories left a deep impression on me about what medical care should be. It should be patient-centered and personalized.

I decided at age 15 that I was going to be a doctor. Four years of college at Emory, four years at the Medical College of Georgia, a year of a rotating internship at Parkland Memorial Hospital in Dallas, two years as a flight surgeon in the Air Force, and three years of a residency in internal medicine back at Parkland followed.

During Christmas of 1975, my wife Nancy and I traveled to Asheville at the invitation of Dr. Lucian Rice and Dr. Ted Hill. I remember touring the hospital with Lucian and meeting many kind, knowledgeable physicians and nurses at both St. Joseph’s and Memorial Mission Hospitals. Several of these physicians reminded me of Dr. Herman and Dr. Cowart. Nancy and I fell in love with Asheville, the mountains, and the medical community here. When Lucian and Ted asked me to join their practice at Biltmore Medical Associates, I accepted.

I began my medical practice here in July of 1976. My first three years with the group were in a rented space in the old Mission clinic building. In 1979, we built the present Biltmore Medical office on Asheland Avenue. Due in large part to the excellent reputation of Lucian and Ted, my practice grew rapidly. I became very active in the Buncombe County Medical Society. I volunteered as a faculty member for the new MAHEC Family Medicine Residency Program and served on numerous committees at both hospitals. My inpatients were evenly divided between St. Joseph and Mission, and I visited both each morning before going into the office. The excellent care was made possible by the growing network of excellent surgical and nonsurgical specialists that had gathered in Asheville. The nursing and allied health care for these patients was exceptional.

I strongly supported Mission’s purchase of St. Joseph in 1998 because I believed the consolidation would further facilitate patient care in Western North Carolina. This has proven to be true through coordinated administrative, nursing, allied health, and medical involvement.

I retired from Biltmore Medical in 2018 after 42 years of practice. At that time, purchase negotiations between HCA Healthcare and Mission Health were nearly complete. Our cherished nonprofit community system was now a large corporate for-profit.

I still keep in close contact with many of my former patients. Over the past two years, I have heard more complaints from these friends about their experiences at Mission. There is still often excellent care from nurses, physicians, and support staff. However, these reports suggest that the reduction in nursing and allied health staff is making it difficult to consistently receive the patient-centered care that was forced upon me as a child and that I have vowed to provide throughout my career. It seems that HCA’s need to make a profit at Mission is coming at the expense of the kind of care that we have all come to expect in Western North Carolina.

All health care systems are challenged by their costs of caring for those in need, increasing diagnostic and therapeutic costs, and staffing needs for those requiring intensive care. Both nonprofit and for-profit systems face the same issues.

Perhaps St. Joseph and Mission should have remained independent hospitals. Perhaps Mission should never have been sold to HCA. Perhaps Mission should have been bought back by a nonprofit health system. These questions and more are being addressed by WNC’s medical and social leadership.

The medical facility landscape in Asheville is changing. We are seeing more services offered by Advent, Novant, and UNC Health Systems. While these changes are certainly welcome, Mission must remain the tertiary and quaternary health center it was when I began working here in 1976. The people of WNC deserve no less.

Dr. W. Virgil Thrash, MD, joined Biltmore Medical Associates in 1976, where he practiced internal medicine for 43 years. He retired in 2019. He and his wife Nancy continue to reside in North Asheville.