Closure of Detroit's Sinai-Grace cancer clinic stuns patient, who worries about neighbors
Anitta Orr was grateful that when she needed radiation treatment for breast cancer, she could get it just 4 miles from her home, at the outpatient medical oncology clinic at DMC Sinai-Grace Hospital.
Orr was stunned when she got a letter earlier this month explaining that the DMC plans to close the outpatient clinic at Sinai-Grace, which has been there for her — and for some of the most medically vulnerable people in her northwest Detroit community — for years.
"I was thinking about the people that I see that come in there in wheelchairs and on walkers and with crutches and who have to get transportation via bus or the shuttles that pick you up and take you there for medical care," said Orr, whose breast cancer was discovered on a mammogram in December 2019.
"But it's also about more about that. The people who work there were told, 'Well, you have to clean this building up and get everything out. Pack it up. We don't know where you're going to work. You have to find your own new job.'"
'If you don't have a car, you're just out of luck.'
The letter suggested Orr could get ongoing cancer care at DMC Huron-Valley Sinai Hospital in Commerce Township, which is about 28 miles away from where she lives — a distance that could take 45 minutes to an hour to drive.
"I can afford to drive out to Commerce Township for my treatments," she said. "I'm retired. I've got a decent income. But I'm thinking about those other people who don't have that. There's no public transportation in this area of southeast Michigan. If you don't have a car, you're just out of luck."
The DMC issued a statement by email to the Free Press, which said:
"After careful consideration and review of community patient preferences, DMC Sinai-Grace Hospital will transition outpatient oncology services including infusion therapy and radiation oncology to nearby cancer programs, effective October 1. This will enable the hospital to reinvest our resources in a way that best meets the greatest needs of the community we serve.
"We are working closely with oncology patients and families to ensure a seamless transition for care. This includes the high-quality oncology services available at the Karmanos Cancer Institute at the DMC Harper University Hospital campus.
"We are grateful for our care teams that have supported these services. Our human resources team is working to assist employees in finding other positions within SGH (Sinai-Grace Hospital) or at other DMC facilities."
Still, not all patients who now get cancer care at Sinai-Grace were given the option of continuing treatment in the city of Detroit at either the Harper University Hospital or at Karmanos, which is the only National Cancer Institute-designated comprehensive cancer center in the region and one of just 54 nationally.
Orr was directed to continue her cancer care at a hospital in Oakland County, but she isn’t sure whether she’s going to pursue that.
“I don’t know,” she said. “I don't really want to have any more affiliation with DMC.”
Black Americans have highest overall cancer death rate
The Free Press asked, but did not get answers from the DMC, about how many employees will lose their jobs as a result of this change, how many people currently get outpatient treatment at the Sinai-Grace Medical Oncology Clinic, and whether the DMC will provide transportation or assistance for patients who lack transportation to alternative treatment sites.
"As far as I'm concerned, they don't care about the community," Orr said. "I understand that there are business decisions, too, that have to be made, but I don't think the DMC has our community's well-being at the forefront at all," she said.
Access to health care in the city — especially cancer care — is critical.
Black Americans are more likely to get cancer and die from the disease than white Americans, according to the U.S. Centers for Disease Control and Prevention; they also have the highest overall cancer death rate than people of any other race. And Detroit is among the nation's largest majority Black cities, according to the most recent census data.
"I'm just feeling very angry and like my hands are tied and there's nothing I can do about it," Orr said. "In other words, I feel helpless and I can't be helpless — not in the city that I've grown up. I just can't do it."
Legacy board predicts 'steady decline in charitable care'
Since 1985, the DMC has served as a safety-net hospital system, providing medical care to indigent Detroiters who might not have health insurance or access to medical care. For decades, it was run by nonprofit and government-owned institutions, but that changed in 2013, when the health system was sold to the for-profit Tenet Healthcare, based in Texas.
As part of the sale, Tenet agreed to continue oversight by an independent legacy board, which monitored the company's adherence to its commitment to serve the Detroit community, providing charity care and continuing in that safety-net mission.
That oversight ended Dec. 31, 2020, along with the DMC's obligation to provide the same level of charity care to patients in the community. In its final report in June 2021, the legacy board wrote:
"DMC’s profit and cash flow contribution to Tenet have been significant and, to a great extent, built upon government-based programs such as Medicaid, Healthy Michigan and Medicare. Implicitly, DMC’s financial success and its safety-net mission are intertwined and inseparable.
"... While we believe Tenet’s charity care commitment is sincere, it is also necessary to respect the fact Tenet has a primary responsibility to its shareholders. It is likely that there will be changes at DMC, and at other Detroit area providers, in the future."
Among the changes the legacy board predicted were:
The potential sale of DMC hospitals and clinics.
Cutting unprofitable services.
A reduction in hospital beds, including intensive care unit beds.
Reduced capacity at Sinai-Grace and Detroit Receiving hospitals.
A "steady decline in charitable care commitment as government programs such as Medicaid and the Children’s Health Insurance Program (CHIP) gradually erode."
Orr wishes this situation could have been handled differently.
"They never communicated to anyone that they were closing this center until I got that letter, and then I got a follow-up phone call from one of the employees," Orr said.
"Why didn't they talk to people in the community? Was there some way we could have negotiated to have the clinic open for three days a week or something? They've done nothing to communicate with the community about what's going on. And that's my issue."
Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Free Press.
This article originally appeared on Detroit Free Press: DMC to shutter chemotherapy, radiation clinic at Sinai-Grace Hospital
