Memorial Sloan-Kettering opens outpatient facility

Branching out from its century-old Manhattan roots, Memorial Sloan- Kettering Cancer Center is preparing to open a 50,000-square-foot outpatient facility in Commack.

While the hospital has been transforming itself into a regional network with treatment centers in leased space in Rockville Centre, Hauppauge, New Jersey and Westchester, the Commack building is its first freestanding operation outside the city.

Memorial Sloan-Kettering Suffolk Outpatient Center received its certificate of occupancy a week ago. The Commack facility, which will employ 60 people, including 12 physicians, plans to begin treating patients within two weeks. It is expected to accommodate 35,000 patients a year.

The center is the latest in a series of moves to become more than an in-patient care provider, as cancer increasingly becomes a disease treated out the hospital.

"There has been throughout all of medicine, including cancer care, a paradigm shift with a much larger involvement of outpatient diagnosis and treatment," said James Harden, executive director of Memorial Sloan-Kettering's Regional Care Network. "And much shorter, more intense inpatient hospitalization."

The Commack center is located on an 11-acre site, which cost $5.5 million. Ewing Cole Cherry & Brot designed the building, which cost $37 million to build and furnish. Construction began in November of 2000.

The facility includes equipment for cancer diagnosis, chemotherapy, radiation therapy, cancer screening and prevention and consulting for surgery.

Inpatient admission and surgical procedures requiring general anesthesia will continue to be performed at Sloan-Kettering's hospital in Manhattan.

Kenneth Roberts, president of John T. Mather Memorial Hospital, in Port Jefferson, said the new facility would benefit patients by providing more treatment options. "As the population of Long Island ages and increases, the incidence of cancer increases," he said. "We will need to have the providers keep up."

But others quietly expressed concerns about Sloan-Kettering's move to Long Island.

They noted that Sloan-Kettering is seeking to grow by winning over patients from local hospitals, even as these hospitals are expanding their efforts to provide cancer care.

Critics noted Sloan-Kettering patients would still need to go into Manhattan, or to another Long Island hospital, for surgery or to treat certain complications. That means there will be a break in the continuity of cancer care.

"You travel to Manhattan for major surgery. They're not bringing that level of expertise to Long Island," said Dr. Theodore Gabig, vice president for cancer services at North Shore-Long Island Jewish Health System. "That is why we can provide a service that sometimes will be complementary to them, providing state of the art care in a more continuous fashion."

Other major cancer providers also have expanded. The Rochester, Minn.-based Mayo Clinic has opened centers in Arizona and Florida in efforts to expand care and build a brand.

Gabig noted Sloan-Kettering is using its name to grow on Long Island, but not establishing surgery center.

"Are they using their name? You bet they are," Gabig said. "Will the quality be the same there as it is in Manhattan and will the continuity be the same? That's the question."

Sloan-Kettering said some doctors are being moved from Manhattan and insisted the new facility will provide the same level of care as that received at its city hospital.

"We are replicating a very successful model of outpatient cancer care, and making it more accessible to patients," said Dr. Harold Varmus, Sloan-Kettering's president.

In 2001, Sloan-Kettering admitted 18,802 patients to its Manhattan hospital, its only center with beds.

During the same period, the hospital reported 450,000 outpatient visits system-wide, ranging from a single visit for a second opinion to dozens of visits for weeks of radiation therapy.

Of the 450,000, about 113,000 were in the suburbs, including about 40,000 in Long Island.

About 44 percent of Sloan-Kettering's patients come from the metropolitan tri-state area. Of those, about 14 percent come from Nassau and Suffolk, Harden said.

By opening centers outside Manhattan, the hospital said it is bringing care to patients, as technology has allowed it to do so.

"This enables us to deliver outpatient services not only more conveniently for the patient, but less expensively," Harden said. "It isn't in Manhattan. It's less expensive to operate in the suburbs. It enables us to bring down significantly parts of the overall cost of patient care."

Sloan-Kettering already has built a substantial operation in providing outpatient care through suburban centers.

The MSKCC at Mercy Medical Center in Rockville Centre handled 30,000 outpatient visits in 2001 in more than 15,000 square feet of leased space.

MSKCC at Hauppauge is located in The Woodlands office building. It handled 12,000 outpatient visits in 2001 and has admitting privileges at St. Catherine of Siena.