When Washington Hospital leaders last fall wanted voters to approve a $186 million bond issue, they were quick to point out that residents own the hospital.

As they asked permission to raise property taxes, they assured that the new facilities that would be built with the money would provide "residents access to the most advanced treatments for heart disease, stroke, diabetes, cancer, and other diseases."

But when it comes to the new orthopedic facility already built, not all residents can gain access. As reporter Ashly McGlone documented, only patients of two surgeons, who have a seemingly monopolistic contract with the hospital, can receive treatment at the new $42.7 million Center for Joint Replacement.

An exterior view of Center for Joint Replacement at Washington Hospital on April 25, 2012 in Fremont, Calif. (Dai Sugano/Staff Archives)
An exterior view of Center for Joint Replacement at Washington Hospital on April 25, 2012 in Fremont, Calif. (Dai Sugano/Staff Archives)

And the office of those two doctors, John Dearborn and Alexander Sah, tells prospective patients who call that they do not treat people on Medi-Cal or Alameda Alliance, which serve low-income patients.

We understand why officials would want only well-trained doctors performing surgery at their hospital and taking advantage of the post-op treatments available at the center. But we don't understand why well-qualified doctors with hospital privileges that allow them to perform joint replacement surgery should have patients excluded from the center.

The guidelines for which doctors can practice at the center -- guidelines Dearborn helped write -- exclude well-trained orthopedic physicians. They seem designed to provide Dearborn and Sah exclusive use of the center rather than ensure that patients receive quality care at reasonable prices.


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The line between the two doctors' practice and the district-owned center has become so blurred that Dearborn and Sah featured the center groundbreaking on their website as if it were their facility. "Welcome to our new building ... ," it began.

While the two doctors are to be commended for donating to the center construction costs and working hard to master joint-replacement techniques, the hospital-owned center belongs to the public. It's not theirs.

Such barriers to competition drive up charges. Joint-replacement surgery at the hospital was already more than twice the state average before the center opened last year. Such elitism leads to a two-tier system of medical care and unnecessarily inflates medical costs. It also discourages other doctors from developing similar mastery.

Equally as disturbing is the hospital's response. Officials are circling the wagons, balking at providing basic information about the center's costs, revenues and financing.

At the same time, hospital CEO Nancy Farber continues to draw an enormous paycheck. In 2011, Farber's total compensation was $936,349, an amount that placed her among the top five paid government employees statewide.

District directors have praised Farber for making Washington Hospital profitable. What they seem to forget is that their mission, and hers, is not just to keep the hospital in the black but also to provide affordable health care to the community -- the entire community.