Some Doctors Call Westlake Village Cancer Unit Unneeded : Health care: Physicians warn of duplicated services and higher costs. But patients welcome convenience of the state-of-the-art center.

The establishment of a new $20-million, high-tech cancer center in Westlake Village, on the far west border of Los Angeles County, has some physicians in that area crying foul.

The center, scheduled to open in mid-May, will be in the Westlake Medical Center. It will have such state-of-the-art devices as linear accelerators that bombard tumors with radioactive particles and computers that guide tiny cancer-busting pellets into the brain’s innermost crevices.

Designed as a one-stop service center for cancer patients, it will offer a variety of chemotherapy and radiation treatments, diagnostic X-rays, bone-marrow transplants, breast reconstruction surgery and psychological counseling. The center will also have its own laboratories and pharmacy.

The operation of the center will be overseen by Salick Health Care, a Los Angeles-based company that has established similar facilities at nine other hospitals, including Cedars-Sinai Medical Center in Los Angeles. Salick will put up half the funds to establish the center in Westlake and will get half the profits it generates.

The hospital--owned by Universal Health Services of King of Prussia, Pa.--had only a 20% to 25% occupancy rate last year. Its administrators and Salick are betting that the new center will attract numerous patients in the area who are tired of driving into Los Angeles for treatments.

“Residents shouldn’t have to travel to Los Angeles if they want to see a foreign movie or go to a bookstore, and certainly not if they have cancer,” said Dr. Bernard Salick, a kidney specialist who founded the company in 1983. “The purpose of our center is to make the Conejo Valley a major focus for cancer care throughout Ventura,” he said.

The Westlake center also hopes to draw patients from Agoura, Calabasas and other cities on the Los Angeles side of the county line.

But several physicians in the area have complained that the Westlake center is unwelcome competition. “Outside of bone-marrow transplant, there is nothing Dr. Salick can deliver in his center that we can’t provide in our own offices,” said local oncologist Dr. Robert Joseph.

“If Universal Health Services has the money,” Joseph said, “it would be better to spend it on other services for this community, which is not just a cancer community.”

Other doctors warn that increased competition in an already-bloated health care system could drive up costs for patients across the board because administrators will have to subsidize underused machines by jacking up the prices of everything from cotton swabs to hospital beds.

“If they’re moderately successful and can reduce our patient load by 30% to 50%, that won’t be enough for them and it won’t be enough for us to upgrade our equipment, pay our support staff and deliver the same quality of care,” said Dr. Paul J. Miller, a radiation oncologist.

And some local doctors complain that Salick’s promise of what he calls “under-one-roof” care is little more than an advertising gimmick. Most patients, they say, use only one service at a time, alternating every few months between radiation and chemotherapy. As for the pharmacy and support groups, they already exist in most hospitals.

But some Ventura County patients so prefer the Salick approach that they now make the two-hour drive to the company’s center at Cedars-Sinai for treatments. “The people at the center are attuned better to you because cancer is all they deal with, and they see it in such volume,” said Moorpark resident Joe Trovato, a cancer patient. “If they had one out in Westlake, it would be just perfect.”

Registered nurse Leigh Ann Heneen, who already works at the Westlake hospital, said she takes her 3-year-old son, a leukemia patient, to the Salick center at Cedars-Sinai because “you can park your car once and do everything you need to do.”

When her son runs a high fever in the middle of the night, she feels more comfortable taking him to the Los Angeles center than a local emergency room, which she said might be crowded with accident victims or people in the throes of cardiac arrest.

The center will not hire physicians. Instead, Salick and Westlake hospital hope the expensive equipment they are installing will lure oncologists to apply for affiliation with the new center.

It could be a hard sell. The centers operated by Salick require oncologists to dramatically shift the way they do business.

Upon joining the center, physicians must transfer responsibility for the technical aspects of care--taking X-rays, mixing chemotherapy drugs, tallying white blood cells--to the health care professionals employed by Salick.

Oncologists say they earn half to three-quarters of their income by providing these services. Fees for the “technical component” of care can cost a patient--and earn a physician--thousands of dollars a day.

Doctors affiliated with the center will retain the right to set their own charges for time spent with a patient. But this income, while substantial, often amounts to less than 50% of a physician’s revenue.

Giving up the technical service fees is a gamble. Doctors are betting they’ll cover their losses through additional professional charges accrued as patients flock to a prestigious new facility. About 300 patients a day come for treatment at the Cedars-Sinai center, and Westlake administrators project a similar volume after a few years.

Members of a community advisory committee from Thousand Oaks, Westlake Village and Agoura Hills, who recently toured the Cedars-Sinai cancer center to see what type of facility will be coming to their neighborhood, said they thought the new center would eventually be accepted in their area.

“There’s some resentment about an outsider coming in,” said Thousand Oaks representative Edwin Trent. “But I think once it becomes a fait accompli, people will start cooperating.”