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Three staff neurologists are expected to exit Western North Carolina's Mission Hospital by the end of September, a report indicated.

Their departure would leave just two neurologists to provide care to hundreds of patients at the facility and across the region, including many patients who have suffered strokes,

Of note, Mission Health was acquired by HCA Healthcare in 2019 for $1.5 billion and has faced other physician departures in the ensuing years.

Speaking on the condition of anonymity to the Asheville Watchdog due to concerns for their careers or potential retribution, the neurologists -- who provide telestroke services to more than a dozen regional hospitals in addition to caring for patients at Mission Hospital -- said they were leaving due to continuously increasing patient loads, the inability of Mission to hire more physicians, and issues regarding pay.

"​​It was just extreme burnout, plain and simple," one of the neurologists said, adding that it "feels like the end of a golden era."

As recently as the end of last year, there were seven neurologists working full- or part-time at Mission Hospital, the Asheville Watchdog reported.

"The neurology group was really one of a kind in this country, and every single neurologist was an outstanding doctor," one of the neurologists told the outlet. "We had a special chemistry working with each other and we were highly regarded by the nurses and other doctors in the hospital. It is a shame that we ended 2023 with seven staff neurologists and will be ending 2024 with two."

"The word 'crisis' has been used to describe our group situation since January," another neurologist explained to the outlet. "My group has used that language."

Mission Hospital is planning to make significant changes to its neurology services in September, according to a complaint to the North Carolina Department of Health and Human Services obtained by the Asheville Watchdog and verified by the exiting neurologists. Planned changes include having a contracted telemedicine company handle after-hours critical care, and potentially making neurology solely a consult service, the outlet noted.

Along with the departures of the neurologists, a number of urologists recently departed Mission facilities or decided to relinquish practice privileges there earlier this year.

Last fall, dozens of physicians from legacy Mission facilities also raised concerns about quality of care and corporate culture in a letter to administrators. "The relationships and deep personal investment that historically mattered to staff across the board have been stifled," the letter stated in part.

"Emblematic of this is the loss of over 200 physicians and countless healthcare staff who have left Mission and/or the medical community since the sale," the letter noted, referring to physician departures in a range of specialties, including family medicine and orthopedic surgery.

As for the most recent departures, Nancy Lindell, director of public and media relations for HCA Healthcare's North Carolina Division/Mission Health, said in a statement that "Mission Hospital has 24/7 coverage which includes on-site neurologists, hospitalists, an emergency care team, critical care team, interventional radiologists, neurosurgeons, and telehealth physicians. We continue to actively recruit new physicians, and our neurology treatment will remain seamless throughout these program changes."

"Mission Health is committed to neurology and our many other advanced care services, and we are committed to caring for our community," she added. "Mission Hospital is and remains a comprehensive stroke center."

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