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Dr. Arvind Agnihotri
Dr. Arvind Agnihotrihandout

Fast-growing Steward Health Care has hired away a leading heart surgeon from Massachusetts General Hospital, part of the for-profit hospital company’s strategy to win back patients who are leaving its system for routine surgical care at major Boston teaching hospitals.

It is not uncommon for Boston hospitals to lure well-respected doctors from competing institutions. But Steward is pumping resources into struggling hospitals it inherited when it bought the Caritas Christi hospital system from the Archdiocese of Boston, intensifying the tug-of-wars in the industry.

Steward persuaded Dr. Arvind Agnihotri to leave his job as director of minimally invasive and robotic heart surgery at Mass. General and oversee cardiac surgery at Steward’s largest hospital, St. Elizabeth’s Medical Center in Brighton.


Agnihotri’s hiring may allow St. Elizabeth’s, which performs about 280 heart operations annually, a relatively small number, to double that caseload, said Dr. Frank Pomposelli, chairman of surgery at St. Elizabeth’s.

“A lot of patients are going to our competitors,’’ he said. “If we put the talent in place, we can legitimately say [to referring doctors], ‘Why are you sending patients there?’ You have to give physicians and patients a choice that is comparable.’’

Preventing primary care patients from leaving Steward for routine surgery is crucial to its strategy of providing high quality care more cheaply than competitors. Steward is signing a growing number of contracts with health insurers that pay it a budgeted amount to care for groups of patients; when those patients get care elsewhere, Steward may have to reimburse a competitor at its rates.

Steward, which is backed by a private equity firm, Cerberus Capital Management, also has aggressively wooed large groups of primary care doctors and specialists, including Hawthorn Medical Associates in New Bedford, which recently left Partners HealthCare, Mass. General’s parent organization.

Brandeis University health economist Stuart Altman said preventing “leakage’’ of patients is “probably the most important thing [Steward] can do. You don’t want to have your high-cost patients leaving you.”


He pointed out that Steward has spent a lot of money persuading physicians and hospitals to join its network, but that it is still unclear whether employers and consumers are going to be willing to stay within its system. “If they do, it will pay off, and if they don’t, then it’s going to be a big failure,” Altman said.

The chief executive of Steward’s 11-hospital system, Dr. Ralph de la Torre, is a former heart surgeon with longtime relationships in Boston, making him especially adept at recruiting doctors.

Agnihotri, who will start his new job Oct. 1, and de la Torre trained together as heart surgeons at Mass. General in the late 1990s. “I’ve kept in touch with him and I’m intrigued with some of the things he’s trying to do,’’ Agnihotri said in an interview.

Agnihotri, who has worked at Mass. General for 12 years, said the Harvard teaching hospital’s strength is in caring for the most complex heart patients, not in employing experimental technology such as robotic surgery, which is promising yet largely unproven, for more routine operations. The hospital has one robot that five departments share, he said. St. Elizabeth’s has two robots, largely used by two departments.

He would not comment on salary, but said Steward is “interested in developing innovative areas and made it clear we won’t be limited by resources. It’s a substantial opportunity.’’


De la Torre brought on Pomposelli, a vascular surgeon he worked with at Beth Israel Deaconess Medical Center, after many conversations, concluding with a daylong visit at de la Torre’s Cape Cod vacation home. Pomposelli started at St. Elizabeth’s a year ago with a mandate to rebuild the 40-physician surgery department.

Aside from plans to recruit a half-dozen surgeons — Pomposelli also hired liver and general surgeon Dr. Scott Johnson from Beth Israel Deaconess recently — Steward is spending money to upgrade its surgery facilities at St. Elizabeth’s. The first $25 million phase involves building a new intensive care unit and more patient rooms. Next, the hospital will add more operating rooms.

Liz Kowalczyk can be reached at kowalczyk@globe.com.