Dr. Matthew Phillips Life is a series of choices, and Dr. Matthew Phillips of Austin Heart Hospital sees those choices as seriously limited if Scott & White Memorial Hospital signs an agreement with Adventist Health System, giving the Temple facility a one-third ownership of Adventist-owned Metroplex Hospital in Killeen.

In mid-September, officials from Metroplex Health System and Scott & White signed a Letter of Understanding that is the first step in forging an agreement they say will augment healthcare options for Killeen and the surrounding area.

Ken Finch, president and chief executive officer of Metroplex, said the partnership will increase options and give the community a greater number of physician choices in the Killeen area.

Phillips disagrees.

The privatepractice cardiologist who sees patients in Lampasas and Killeen said competition is a good thing, but it needs to be taken in context.

"Look at Williamson County. It has four hospitals all competing for patients, physicians and more services," he said. "That's a good thing. The more competition there is, the better your choices."

Phillips said concerns from Austin Heart Hospital physicians, some of whom also practice in Killeen and Lampasas, is that Scott & White -- one of the largest hospitals and an employer of numerous physicians -- will cause a loss of private practice. "It is hard to recruit physicians to come to an area where a large hospital is the only choice."

Concerns also center on what Phillips calls the consolidation of the two medical facilities. "Call it what it is. It is a consolidation. The bottom line is if you have a big health system that owns 30 percent of another health system, it's a consolidation."

The heart specialist, who has been practicing in Killeen and at Rollins Brook Community Hospital in Lampasas for more than a decade, assures his patients Austin Heart is here to stay. "We will continue to provide inpatient and outpatient services as long as we are allowed to do so."

Independent physicians, such as Phillips, do not receive a sal- ary or compensation from Metroplex or Adventist Health System. "They do not in any way pay my salary. But I have been a strong supporter of Metroplex for years," he said.

Phillips noted that he prefers the Adventist Health System compete with Scott & White rather than join the conglomerate.

"Scott & White wants to extend its reach, which is fine," he said. "We are concerned that if they bring in their physicians, it will force others to go out. In the end, it leaves patients with fewer options." And fewer options, he added, can have repercussions such as a lower level of service and higher costs.

Phillips acknowledged that Adventist Health System has always been a strong partner of Austin Heart, but it could be the Killeen hospital's concerns over reimbursement costs was the motivation for Metroplex to seek better payers and better contracting.

The physician likens the situation to a small business opening up next door to a Super Wal-Mart. "It's not that Wal-Mart's bad, it's just that it's not a good business decision for the small company.

"We always thought competition was the way to go, and we had hoped Adventist would stay independent."

Phillips, who earlier in his career practiced at Scott & White as did three of his partners, still has numerous colleagues and friends at the Temple medical facility. "I stayed in the area because I liked it here. And in 1996, I went into private practice with Austin Heart."

Phillips, who resides in Temple, was named the heart hospital's president three years ago.

Austin Heart has been sending physicians to Lampasas for the past 17 years, he noted.

The heart specialist sees patients in Lampasas each Tuesday and Wednesday but also consults by phone with local physicians and has access to patient records White will limit choices online.

"I won't stop coming here," he said of Lampasas. "This is one of the highlights of my practice. I love it here, and my staff loves it here. This is where I feel like I am a real physician, and as long as we are welcome to see patients and are accepted at the hospital, we'll stay."

Rollins Brook hospital's assets are combined with those of its parent company -- Metroplex -- which gives Scott & White an interest in the Lampasas facility if the Temple hospital acquires the one-third interest in Metroplex.

That acquisition by Scott & White, Phillips said, will cause a dilution of private practice and will limit patient choice.

"Will Metroplex grow where it needs to be when Scott & White has just made a major investment in a new facility in Temple?"

Said Phillips: "I think Adventist is a good, strong system -- much stronger than Scott & White -- and they should stay independent."

The heart specialist said Metroplex's CEO Finch understands physicians' concerns. "And I understand the financial realities hospitals have to face, and they have to make the decisions they think are best for them. But we can agree to disagree on their decision.

"But with competition, a business has to focus on customer satisfaction. When there's no competition, they focus on corporate satisfaction. I've seen that happen over and over. And over time, that's what happens.

"The quality suffers. It's all about choice and competition."

Phillips is one of 50 physicians who signed a letter to Metroplex leaders voicing their conerns. "I signed that because I had concerns then, and I still have concerns now."