The Mission SECU Cancer Center in Asheville // Watchdog photo by Starr Sariego

Mission Hospital’s cancer center will lose its last remaining medical oncologist next month.

Dr. Michael Burke, the lone oncologist listed on the cancer center’s website, told Asheville Watchdog he will leave Mission’s medical oncology practice at the end of November.

Burke said he didn’t know whether another medical oncologist would be hired before he left.

“I’ve been preparing for there not to be anybody come Nov. 27,” Burke said. “That has been, I think, the only responsible thing to do on my end.”

The Watchdog emailed Mission Hospital spokesperson Nancy Lindell a number of questions, including:

  • Will there be any medical oncologists at Mission after Burke’s departure?
  • Has Mission hired a new medical oncologist yet?
  • If so, whom have they hired?
  • If not, is there any timeline on when a new medical oncologist will start? 
  • Where is Dr. Burke going? 
  • Greg Lowe has said in letters to the attorney general’s office that there are no plans to close medical oncology practice or reduce services: How will that be possible if there are no medical oncologists?

Lindell answered none of the questions, instead responding in an email with largely identical language used in her responses for previous Watchdog stories about doctors leaving the Mission system since HCA Healthcare acquired it in 2019.

“As stated previously, Mission Hospital continues to have a robust team delivering oncology services in a range of specialties — breast, colorectal, hepatobiliary, gynecological, infusion, interventional, medical, orthopedic sarcoma, pediatric, plastics, radiation, surgical, thoracic, urological and more,” Lindell stated.

“We have relatively the same number of physicians on our medical staff today as we have had in previous years,” Lindell added. “There are several oncology options in this community.”

Dr. Michael Burke // Credit: Mission Health

Burke said his “overwhelming” concern right now is for his patients and the future of their care.

“I’ve been working, I would say tirelessly since I submitted my resignation in May, to make sure that all the patients have continuity of care,” Burke said. “I’ve been assuring them that we’re continuing care for as long as possible, so that nothing is missed, nothing is dropped until the day they meet a new provider.”

He said he has been telling his patients they need to be established with a new oncology group outside of Mission.

“I’m really trying to make sure that they have a continuity of care, and they’re not subject to the vicissitudes that everybody’s experiencing right now with all the changes and everything at Mission,” Burke said.

Burke said he would continue practicing oncology “up North” but did not want to say where exactly.

Assistant Attorney General Llogan Walters wrote an HCA executive on June 20 about the North Carolina Department of Justice’s concerns that the practice had just one medical oncologist “where it once had fourteen” and warned the hospital needed to “restaff the medical oncology department immediately” or risk litigation.

Llogan’s letter asked HCA North Carolina Division President Greg Lowe to provide the number of oncologists employed by the Mission medical oncology practice for each month since February 2019, the name of each one employed by the practice since January 31, 2019, and the dates of their first and last days of employment.

Lowe responded in an Oct. 4 letter obtained by The Watchdog that included a chart showing the dates of employment for the five full-time oncologists hired since early 2020. Four have left the hospital. Burke’s dates of employment are listed as July 6, 2021, to Nov. 26, 2023.

North Carolina Attorney General Josh Stein did not object to the $1.5 billion sale of nonprofit Mission to for-profit HCA after the corporation committed to his demands for greater consumer protections.

Nashville-based HCA Healthcare’s 15 commitments included promises to “keep material facilities open for at least 10 years” and “continue specified services for at least 10 years.”

Despite the departures, Lowe’s letter stated that the oncology practice will remain open.

“Mission Health System (“Mission”) remains deeply committed to providing quality oncology services to cancer patients in Western North Carolina, and there are no plans to reduce such services at the Cancer Center nor to close the Mission Medical Oncology practice,” he wrote.

Lindell, Mission’s spokeswoman, pointed in May to Messino Cancer Centers as a partner, saying that although Mission was down to a single medical oncologist, the hospital “work[s] very closely with other programs in the area such as Messino Cancer Center and GenesisCare Surgery, who continue to operate every day at Mission Hospital.” 

Now, the last remaining staff medical oncologist is departing, GenesisCare Surgery has declared bankruptcy causing the loss of some local oncologists, and Messino Cancer Centers announced to acute leukemia patients that it would no longer send them to Mission, citing potentially dangerous system failures at the hospital.

An excerpt from Lowe’s Oct. 4 shows Burke makes five medical oncologists who have left Mission since 2021.

Lowe’s letter follows another he sent Stein’s office in May, saying Mission was recruiting for three open positions but was encountering “headwinds in hiring and retaining oncologists.”

HCA’s career website currently has a job posting for a Mission medical oncologist and a breast medical oncologist.

In response to a request from Stein’s office, Lowe provided statistics on the medical oncology practice but warned they may not be precise due to the way data is entered.

The statistics showed that Mission had already canceled 45 medical oncology appointments between January and June this year, compared to 60 for all of  2022, 51 for 2021 and 45 for 2020.

This chart included in Lowe’s Oct. 4 letter shows the number of medical oncology appointments Mission has canceled over three years and six months.

Lowe also fulfilled the attorney general’s request for data about referrals made to non-Mission oncology practices from the beginning of 2019 through June 2023. It showed nearly 3,000 patients have been referred out, including 232 in 2023 and nearly 1,500 in 2019.

This chart included in Lowe’s Oct. 4 letter shows the number of referrals Mission has made to other oncology practices over four years and six months.

Lowe told the attorney general’s office in an Aug. 21 letter that Mission medical oncologists had seen more than 3,000 new patients between January 2020 and June 2023. Medical oncologists had seen 563 new patients in 2023 alone, according to the data Lowe provided.

This chart included Lowe’s Aug. 21 letter shows the number of new patients Mission medical oncologists have seen over three years and six months.

The Watchdog in April 2022 first reported on a depletion of doctors including medical oncologists at Mission. In May 2023 Mission confirmed two doctors had left medical oncology and attorney general spokesperson Nazneed Ahmed told The Watchdog the office was examining issues there.

Mission has faced growing scrutiny from Stein’s office this year after its decision to shutter a cancer center pharmacy in March, the exodus of its medical oncologists and, most recently, the decision by Messino Cancer Centers to stop providing some acute chemotherapy at Mission facilities.

That decision cited “ongoing system failures” at Mission Hospital, which Messino said were going to ultimately harm patients, and will force some patients to seek care in Charlotte, roughly two hours from Asheville, or Duke Cancer Center in Durham, nearly three and a half hours away.

Messino Cancer Centers have practice privileges on Mission’s floor K9, which is separate from Mission’s cancer center. 

Stein’s office has written four letters to Lowe since late February, asking for information about cancer services. The most recent, dated Sept. 29, asked Mission how it will address Messino’s decision to stop providing acute leukemia care at the hospital and whether GenesisCare’s recent bankruptcy would affect services at Mission.

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email 

45 replies on “Mission to lose last remaining medical oncologist”

  1. Good God, is there anything that can actually be done about this? HCA is destroying a once-great hospital.

  2. I am one of the new patients seen at Mission in January. Since, I have moved my medical oncology needs to Duke, despite the nearly 4 hour drive. It is well worth the peace of mind, knowing the doctors there are focused on the latest research and technology, and avoid the chaos that they won’t lose their jobs when Mission shuts down. When you are fighting cancer, you don’t need the extra chaos and stress of worrying about who your dr is going to be.

    1. You said it. Dependable, top notch care at Duke (or anywhere but here) vs. whatever crumbs of care you might find here. It’s a horrible situation for anyone with cancer. I wonder how far this will continue to deteriorate befor we just say we don’t have a hospital in Asheville. We only have a bare bones facility now.

      1. They just got approved to build a new freestanding ER, don’t forget. Their existing ER is a documented dumpster fire, but let’s give them another one. It’s way beyond just a cancer center problem, it’s hospital wide system failures with absolutely no state or federal oversight and plenty of patient horror stories.

  3. This is simply appalling. Stein has got to step up and do far more than send letters. Mission/HCA has clearly gotten the message that there will be no enforcement of standards for their patients. Meanwhile they’re paying out exorbitant salaries and bonuses for executives. Who besides Stein has any recourse?

    1. Who indeed? Have we not contacted everywhere with any authority to shut this junkyard of a hospital down? Who can help us?

    2. That’s the question. We HAVE to do something. Even a single restaurant with the documented failure to provide safe food for their customers would have been shuttered long ago. Yet, some idiot approved they get a new emergency facility in Candler. How? Why? It’s obscene.

    3. The contract was all about “maintaining services.” It said nothing about quality of services. And it was to maintain “services” for 10 years, which is about 1/2 way done already. They just need to put up with some more useless letters from this AG or the next one for a few more years and they are golden. Is the Watchdog going to report on the Gibbens Advisors sham meetings scheduled throughout WNC in October?

  4. This is horrifying. The hospital has clearly been aware of all this for months. Yet, it seems to focus on optics, rather than patient referrals.

    1. They’re past caring about optics now. They know they might get a letter or two of reprimand from the AG and that’s it. There’s nothing for them to fear.

  5. “North Carolina Attorney General Josh Stein did not object to the $1.5 billion sale of nonprofit Mission to for-profit HCA after the corporation committed to his demands for greater consumer protections.”
    It doesn’t appear that there were any consumer protections built into this ill advised sale, correct me if I’m wrong, it seems it was an illusory contract with nothing promised to the people and no means of enforcement. Josh Stein and HCA are nothing more than pen pals at this point. Letter writing over the span of months and years and no legal remedy to protect patients from a dangerous, greedy hospital.

  6. I would never pretend to understand the worry that any oncology patient would experience in our local community. My husband lived through cancer twice and it is beyond stressful even when you live 20 minutes away- my heart goes out to all. I also don’t intend to try to defend the healthcare system at Mission which at one time – many, many years ago now- had a very fine hospital system. They could not continue to keep up with their past outcomes and financial commitments – that is the reality, so this is what happens when you look for a buyer- Mission Healthcare System did their very best with asking Josh Stein’s office to intercede and provide oversight.

    After over 30 years working in healthcare- varying areas and specialties- I have watched many great systems in the last 15 years struggle to survive, as awful as it sounds, it is not unique to Asheville- leaving Mission and HCA out of the discussion. No, I never worked for either company.
    Where my comments are going is that there are many factors that influence the these healthcare systems around the country- retirement of doctors and nurses; baby boomers retiring; band-aid fixes that help only for short times and hundreds of different kinds of insurers any given moment stressing the healthcare system to it’s max. It is easy to read about – slamming Mission Health over and over does not help the good people who work there ( and there are many) nor to help find new specialists. We have a shortage of docs and healthcare professionals everywhere in the nation- and in the world. Just speak to the UK or Canada or Germany. We are not immune-

    I feel for the clinicians who don’t have another referral source when they have decided to leave a system- for those of us who have care needs, it is good to be looking outside of the immediate area to see what’s available. This hospital system will get better- and it has already in many areas- as it tries to reconfigure and reorganize. None of this can happen overnight.

    1. HCA doesn’t have a history of getting better. They have ruined FL. They are ruining Wilmington along with Asheville. HCA isn’t being slammed–they’re being called to account for inexcusable negligence of the community while they suck insane, massive amounts of revenue brought in here. We are their cash, and sacrificial, cow. Slamming HCA is all we can do to support the clinicians and all the health care workers suffering moral harm under the inexcusably reckless management by HCA. It’s a business decision. NC law makes it hard to impossible to hold them financially accountable. Cheaper to let most of it fall apart, and make sure the profit centers related to heart tower and orthopedics hold onto their reputations. As one frustrated cardiologist stuck in the system told me, “Our corporate overlords won’t let us practice medicine the way we could and should”. They play the system well, including the largest medicare fraud in US history in FL while Rick Scott was running the joint. I see apologists on every local social media including this fine news organization’s comment section. “It’s bad everywhere”. Well, not as bad as this. Good business people who consider patients and the community as stakeholders–not just shareholders and management–could leverage Asheville’s popularity, wave of new residents, and the great things about living here to attract the best of the best docs and nurses. But, sadly, the best of the best have fled in spite of Asheville’s attractiveness. Travel nurse groups are dropping HCA Asheville. Some people have moved away because we don’t have a hospital we can count on. Some who hoped to return home to retire have steered away. SO grateful for the staff who remain, and do all they can, and succeed spectacularly so often in spite of HCA. They deserve so much better, as do we.

  7. This is a sad situation for cancer patients in the western part of North Carolina. Sadly, this could have been prevented before Mission St. Joseph Hospital was sold to a for profit corporation. When a hospital is run by a for profit corporation you can be sure the patients will suffer.

  8. How soon folks forget that the head of Mission was negotiating a lucrative consulting contract with HCA at the same time he was negotiating the sale. No conflict there, I guess. Other investigations suggested that other bidders for Mission were discouraged. Also don’t forget that non-disclosure agreements were enforced against those involved in the process. I wonder why they did that? No, for sure, nothing suspicious at all. Glad we moved to Raleigh where medical care is reliable and available.

  9. Given HCA’s super sketchy past, anyone with 1/2 a functioning brain could have seen this coming. Too bad the NC AG was not up to the task 🙁

    1. And too bad he assumes that writing a letter to HCA will look like he’s concerned. He’s not. All he’s concerned about is getting WNC to vote for him for governor. He needs WNC votes but he’s done NOTHING for us. No one that has Mission for a hospital should vote for Josh Stein.

  10. HCA has a horrible reputation among providers and patients nationwide. They cannot recruit good doctors and anyone who could leave has left. It should make you wonder about the quality of doctors that remain or the new ones to come in. They prefer to replace MDs with new grad mid levels, PAs and Nurse Practitioners to keep costs down and because they won’t rock the boat. It is only getting worse from where I sit. Apparently Stein didn’t google HCA before he inked the deal.

  11. If it all possible, the attorney general should sue HCA to force it to sell Mission to a competent hospital company. SOMEBODY needs to conduct a rigorous investigation of how a flourishing nonprofit hospital came to be sold and why it has been run into the ground since then.

    1. Mission had been mismanaged for years before this, but the care remained good enough for the most part.
      The level of care at HCA Mission is downright dangerous. Doctors from outside and inside will tell you not to go there if you want to stay alive.

      1. First hand recent experience at Mission. Way understaffed. Meds hours late, even pain meds. Labs not even looked at for 72 hours for c-diff! Doctors may or may not show up. Wound care ignores orders for 3 days. Slop for food if you get any. If you have no one to stay with you to advocate on your behalf, you’re in serious trouble. These are facts.

  12. Please let us know about Dogwood Trust. I thought they might have some influence or regulation over HCA. What are they doing with the 1.5 billion? This has been confusing for AVL citizens and the story has been stretched over quite a few years.
    How do newer residents get an idea of the saga?

    1. Dogwood Trust just seems to have the taken the money and ran. Just another organization created to dole out massive salaries and compensation packages.

    2. Dogwood was just a front to smooth over the deal. They do not involve themselves in actual healthcare. They are supposed to give money back to the community to make HCA look like they care. They don’t.

  13. A teen speeding down Biltmore Avenue to Asheville High might get more consequences for actions than HCA. Come on NC, do something, please!

  14. As I’ve said before, contacting Stein’s office is an exercise in futility. Stein is running for Governor, and I’m sure his campaign will be handsomely rewarded for him not stepping up to offer serious consequences to HCA. We the people will have to do something.

    1. Agreed, we can start by not voting for him. I question his judgment and character after this ordeal. Treasurer Dale Folwell spoke up loud about it on national TV, but Stein wouldn’t back him up. NC politics have always been a bit on the shady side. Don’t forget all that tobacco money that ran this state forever. Corporations rule here.

  15. Remember this when you vote for our next governor. This deal did not pass the smell test. Nobody will do anything to intervene into this disaster. HCA has billions and Mission is their top money maker. They are just laughing at us. Funny how they get approved for a new ER while everyone looks the other way.

  16. I had the sad misfortune of having to visit Mission ER when I couldn’t breathe. We were there 6 hours and no X-ray of my lungs just BP and oxygen levels. Meanwhile I was on the verge of collapse and terrified. A nurse finally suggested that we should leave and seek care elsewhere as it was unlikely that any physician would get to me that night. So we signed me out and care was arranged for me elsewhere the next day. How can an ER refuse a STET order. ? Come on NC, shut this place down

    1. I agree. My now deceased husband was un the ER over 12 hours. He had cancer and heart issues. After he was finally stabilized there were no beds for hours to admit him. The floor they finally placed him on ( he was moved 3 times ) had a whole wing not being used..literally just empty of anything or anyone.. ridiculous…yet they want to let them try again to build a new ER West? I thought Advent was the liw bidder? They already turned down Mission once so now they ok them ? Come on their track record is not good…let Advent move forward. If it’s given to Mission it will not be good

  17. Is Stein’s office sort of the equivalent of the Asheville Water Department at the state level-kinda ignoring the closed valve?

    Maybe he’s too busy running for governor.

  18. At what point do we hold the NC Attorney General’s office accountable for letting HCA/Mission obliterate quality health care in WNC. Sending a letter every couple of months doesn’t seem to be effective in slowing down the destructive course Mission is on. I have many friends that are Doctors, RN’s and administrative staff at Mission and they all are very frustrated with HCA’s direction. They frustration runs over to the lack of urgent leadership from the state’s Attorney General and his office.

  19. There is no sense of urgency, that’s the problem. A lot of bad can happen to people while these letters between the AG and HCA go on for months accomplishing nothing. It looks like a half baked attempt by the AG to fool us into thinking he is doing something. His top job is to protect consumers from fraud. He ought to get at it or call the Feds in.

  20. I think we should stop calling it mission hospital. That name, and the quality of care it was associated, died the day this sale was approved. It should be called what it is, The Hospital Corporation of America. Which tells you everything you need to know about this company. I moved here 18 yrs. ago because of the outstanding hospital here, and watched with dismay when the hospital changed hands, knowing that the quality of care would drop off considerably. The state should also have known this, and never approved this dismal sale. Shame on stein, and shame on the board of mission for approving this.

  21. The only thing that will make this hospital act is for Medicare to investigate and find evidence of serious patient danger enough to threaten their medicare certification. Then they will give them time to formulate a plan to fix the problems, but nothing ever gets better. It’s just a game. Anyone who has worked in Healthcare should know this. But we have a shortage of NC/CMS investigators apparently, as the nurses have been requesting investigations for over a year. Once a community is plagued with a bad hospital, there is usually no way out of it. Look at other HCA’s around the country. Cockroaches in Surgery settings (FL) medical equipment catching fire and killing patients. (TN) It goes on and on. To seek care elsewhere or not at all are the only options it seems. God help you if you have a medical emergency and end up there through no fault of your own. We can’t expect the ones who broke the healthcare here to fix it. As for Josh Stein, his focus is on running for governor and apparently doesn’t need the votes in WNC to win.

  22. Messino Cancer centers, known previously as Cancer Care of WNC in which I was a previous partner before retiring, has provided high quality Oncology care for nearly 30 years. Despite the disaster which Mission hospital has become via HCA, no one should have to leave this community for care!

  23. The central issue is who provides healthcare and why they do it. As long it is provided by for-profit corporations, our health and well-being will be secondary to profits. When non-profit, community-based, community-owned healthcare facilities are available, profits will not be a motivator. The best solution to this problem is for the legislature and governor to heavily tax profits made by for-profit healthcare providers. This would remove their motivation to exist in our state, the funds could be used to support non-profit facilities, and we would ultimately have care that focuses on the well-being of individuals in the community.

  24. Why did Stein approve this deal to begin with? Why was the deal so secretive? What are the remaining 13 of 15 “conditions” they must meet? If they are not meeting the conditions of the contract, why isn’t Stein suing them? Writing letters is meaningless, there needs to be action backing this up. We will all do well to remember this debacle when voting for Governor. Stein is not the candidate.

    1. The 15 Commitments of the contract are a complete joke. They are purposely vague. One is actually for them to keep the hospital open for ten years. Also, quality of care is NOT included. There is no recourse, sad to say. But NONE of our officials will tell the public the truth. This bell cannot be un rung, if it can why hasn’t it been?

  25. Advocacy Allies is greatly concerned with the lack of solution minded action. Yes Mission shows 2 open positions, but no oncologists want to be on an island in a system unsupportive of it’s physicians and their staff. We would like to see an independent oncology practice move into the cancer center, leasing space from Mission HCA, but with full practice autonomy. That practice would need to have privledges on the infusion floor to oversee chemotherapy and other life-saving treatments provided by Mission HCA. In addition, that independent practice could choose to open triage and other much needed services in the cancer center. Mission HCA would need to comply with Messino and the new oncology practice to meet care standards for patients on K9. With profits soaring, they have the financial aptitude to withstand independent practices in their facilities. As a community, we cannot continue to stand by and watch crucial health care services disappearing over greed and a refusal to meet safe care standards.

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