A Kansas Cardiologist With His Eye on the World
By EDMUND NEWTON (NYT)
WICHITA, Kan. -- After a slow month or two, the $20 million Galichia
Heart Hospital, which opened in February on the east side of this bustling
agribusiness city, took off like a cornfield in July.
Medical staff members have been performing almost 18 angioplasties a day
and more than a dozen bypasses and other cardiovascular procedures a week --
there is a waiting list to get in and profits are mounting.
''For a new business, it's been pretty extraordinary,'' said Dr. Joseph
Galichia, the 60-year-old Kansas native whose name is over the front door.
The investment group that remodeled an old insurance building on a
windblown lot and filled it with high-tech equipment is not giving exact
profit figures. But Dr. Galichia says that with projected earnings this year
of better than $5 million, the investors -- a variety of entrepreneurs and
physicians from Wichita -- can be safely assured that their initial outlay
will be covered long before the hospital reaches its fifth anniversary.
Dr. Galichia, a cardiologist respected among colleagues as much for his
business acumen as for his skill with scalpel and catheter, has parlayed his
reputation as a cardiology research pioneer into a burgeoning enterprise.
The group is close to finalizing plans for Galichia facilities in Texas
and Arizona, and even now Dr. Galichia is in Beijing, lining up investors
for a hospital there that will carry his name. Eventually, he said, there
may be as many as 30 Galichia heart hospitals worldwide.
Dr. Galichia is also one of 15 investors who will open a separate 60-bed
hospital in Beijing next year called the Beijing International Heart
Officials at larger, acute-care hospitals in Wichita are less than
thrilled about Dr. Galichia's success, though they welcome Galichia's
doctors. Wesley Medical Center, with which he was previously affiliated, has
lost better than a third of its cardiovascular cases since the specialty
hospital opened. Wesley and Via Christie Regional Medical Center, the
largest nonprofit hospital in town, were already under pressure from another
specialty operation, the Kansas Heart Hospital.
Wesley's chief executive, David S. Nevill, said the new institutions were
an inevitable result of a squeeze on doctors by Medicare and other
reimbursement agencies. ''The idea of running faster to maintain the same
standard of living is not attractive,'' Mr. Nevill said. ''Doctors are
exploring other avenues for personal financial benefit.''
In recent years, cardiac care has represented 10 percent of the
hospital's revenue. But with the rise of ''boutique'' hospitals, Mr. Nevill
said, ''we're staring down the barrel of a crisis.''
Dr. Galichia questions the dire prophecies, saying larger hospitals can
take up the slack by concentrating on other services. ''What's happened in
the past,'' he said, ''is that hospitals have taken a goodly portion of
money from cardiac and not reinvested'' in cardiology.
Business has always come naturally to Dr. Galichia. ''Growing up on a
farm, you learn to be cognizant of your costs,'' he said. He opened the
first Galichia facility in 1984. Until December, it operated out of two
cramped stories in a medical building near downtown Wichita.
Partly, he was driven by the entrepreneurial instinct, Dr. Galichia said.
But the specialty hospital seemed to make a lot of administrative sense,
too. Cardiologists say it can optimize treatment by sidestepping the
bureaucracy of large general hospitals. ''When I need a piece of equipment
that costs $1 million, I have to compete with 30 other departments,'' said
Dr. Steven Ramee, a cardiologist at the Ochsner Clinic Foundation in New
Orleans, who has worked with Dr. Galichia. Heart hospitals ''don't have the
overhead problems we do -- they can streamline.''
Dr. Galichia is a pioneer in the use of angioplasties -- sending probes
to the heart through an artery in the groin and using balloons blown up
intravenously to clear clogged arteries -- and has instructed about 200
fellow cardiologists in the technique.
He stumbled on the procedure in 1978, two years after he had opened a
practice in Wichita. While traveling with his family in Europe, he picked up
a German newspaper with the headline: ''Doctor saves life with balloon.''
The story was about a Swiss doctor, Andreas Gruentzig, who performed the
first angioplasty the year before. Realizing the revolutionary potential for
the technique, Dr. Galichia persuaded Dr. Gruentzig to train him.
In 1980, Dr. Galichia performed the first angioplasty in Kansas. The
procedure has been widely credited with saving countless lives and greatly
reducing the pain and healing time associated with bypass surgery. About a
million angioplasties a year are now performed in the United States,
according to the American College of Cardiology.
Dr. Galichia has a 20 percent stake in the hospital through Heart
Hospitals of America, a holding company set up to run the Galichia
Photo by Steve Rasmussen for The New York Times