After operating the Island’s only house call medical service for the past two and half years, Michael Michotek, M.D., is ending his practice amid issues with his patients seeking care at the Martha’s Vineyard Hospital, according to a letter he submitted to The Times.
“This is a rural access hospital, one lab, one X-ray, one cardiology, that all of us are forced to use. There should be no monopoly on healthcare,” the letter states in part. “My patients are being treated differently by their mere association with me. I cannot, and I will not continue to practice medicine that increases my patient’s liability as well as mine. Thus I plan on closing my practice Oct. 1, 2021.”
Michotek is a former hospital primary care physician (PCP) who left in 2018 after one year on the job. At the time, both the hospital and Michotek declined to give details about his departure.
After leaving the hospital, Michotek opened his house call practice, catering to people with chronic and complicated medical problems.
In his letter, Michotek states that his routine during his house call practice would be to drop off patient lab slips and X-ray requests before visiting his inpatients. But in April, he would have to come back during hospital visiting hours.
“Then, unexpectedly, on April 5, 2021, I was met in the front lobby to be informed of a memo stating, ‘If Dr. Michotek wants to see his patients, he can come back during visiting hours.’ Several employees informed me of the same the following week. Almost three months later, I still have not received official notification or explanation. I guess they showed me, no more free visits or favors for my patients!” Michtoek wrote. “This is clearly a disservice to my patients.”
In a statement to The Times, hospital president and CEO Denise Schepici stated that when Michotek resigned from the hospital, he no longer had privileges.
“The hospital cannot grant unfettered access to anyone who does not have privileges because of our obligation to protect the privacy of patients, who are in our care. This is not only our priority, but it is a mandated federal regulation through the Health Insurance Portability and Accountability Act (HIPAA),” Schepici said. “This was especially important during COVID last year, with the restrictions and safeguards put in place to protect our patients, staff, and all visitors to the hospital. Dr. Michotek is welcomed to see his patients at the hospital during regular visiting hours, which is our policy for all nonstaff providers.”
Schepici went on to say that Michotek has access to his patients’ records through the Massachusetts Health Information Highway. “The hospital offered to assist him with this process, but as of now, Dr. Michotek has not accepted our invitation,” she said. “We invite anyone who needs a primary care physician to call our patient access number, 508-684-4500.”
Michotek’s letter goes on to say his patients have “specifically and unfortunately” not had the same level of PCP access or continuity of care as patients with PCPs employed by the hospital.
“Year after year, admission after admission, discharge after discharge, my patients and their families inform the staff I am their PCP, yet nothing is done to facilitate this. Whether the ER, X-ray, acute care, this especially applies to discharge planning. I’m almost never notified of their admission, almost always called upon discharge, most of the time not even knowing my patient has been admitted. Even when I ask them to facilitate this charge, nothing is done,” his letter states.
In an email statement, hospital communications specialist Marissa Lefebvre said a physician without privileges can access Mass Health Information Highway for X-ray requests or lab slips.
“Dr. Michotek has not taken us up on our offer to show him the process,” Lefevbre wrote. “Dr. Michotek has the same level of access that any other visiting physician would have to the hospital.”
Michotek additionally sent his letter to the Joint Commission of Hospitals, U.S. Senator Elizabeth Warren, and state Rep. Dylan Fernandes. He also sent a petition with 50 of his patient’s signatures to Mass General Brigham and the commission.
Michotek declined repeated requests for comment beyond his letter. “Whether you like me or not, are a patient of mine or not, it’s your future healthcare. The patients need to speak up,” Michtoek wrote. “We shall see if this is the standard of care/standard of treatment at other rural access hospitals in the United States.”