Years ago Mississippi, like many other states, enacted a Certificate of Need law. This law prohibited new medical construction or services without prior state approval.

This was intended to reduce the cost of medical care by eliminating duplicate services.

Several years later a Natchez physician wished to build his own endoscopy outpatient clinic, but could not get a Certificate of Need because one of the local hospitals had the CON for endoscopy.

Consequently, he and a few other physicians, built their clinic in Louisiana where the CON law had been repealed.

Natchez lost a fine facility and several physicians.

A few years ago, Natchez Regional Medical Center built a heart cath laboratory with state-of-the-art equipment.

A heart specialist, able to utilize this lab, was brought to Natchez and we had a great heart service without having to travel out of town for care.

When the heart specialist relocated elsewhere, we lost those services.

After protracted searching, Natchez Regional Medical Center recently brought to Natchez a heart specialist able to manage the cath lab for the benefit of Natchez patients.

They arranged for him to be associated with the prestigious Jackson Heart Clinic so there would always be coverage for patients of the cath lab. Because the lab had been unused for longer than a year, it required a new CON.

That application for a CON was opposed by Natchez Community Hospital. It claimed it should be given the CON, even though it had never provided those services or had a heart cath lab and equipment.

The state wisely awarded the CON to Natchez Regional Medical Center.

Now what?

The loser, Natchez Community Hospital, has filed for review of the decision, effectively blocking use of the cath lab.

Legal proceedings can take many months or years to complete.

In the meantime, the cath lab can’t be used, and Natchez patients continue to suffer the inconvenience and expense of traveling out of town for heart services.

This brings to mind two things. First, Aesop’s fable about the dog in the manger keeping the oxen from the hay although he couldn’t eat it, and second, that our legislators should get Mississippi’s CON law repealed.

Bruce M. Kuehnle, M.D., is a retired Natchez surgeon.