PREVIOUSLY

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Dr. Joseph Arcidi. | Submitted.

In mid-December of last year, local cardiothoracic surgeon Dr. Joseph Arcidi was in London, England, with his family, getting ready to deliver a talk at the 10th Annual International Coronary Congress, when his cell phone started going crazy with incoming texts. He decided to ignore them until after his address, at which point he picked up his phone and started scrolling through the messages.

“As I read through things after my presentation, I turned to my wife and said, ‘Huh! Honey, I guess I resigned!’”

This was a surprise to Arcidi, who’d been serving as medical director of cardiothoracic surgery at Providence St. Joseph Hospital in Eureka for the past four years. During that time, and under his leadership, the hospital’s open-heart surgery program had made great strides, showing dramatic improvement in patient outcomes. Arcidi was proud of the turnaround he’d helped to steward, and while he’d heard that the heart program was in financial trouble, he had no intention of resigning.

Still, the financial problems were real. Despite the improved outcomes, patient volume in St. Joseph’s heart program had not increased, Arcidi told the Outpost in a recent interview. And Providence, a Catholic not-for-profit health care system that now owns 51 hospitals and more than 1,000 clinics across the American West, was suffering six-figure operating losses quarter after quarter. 

For about a year and a half, Arcidi had been hearing from local and regional administrators that Providence was considering closing the heart program in Eureka, strictly for financial reasons, he said. 

Yet here he was in London, getting barraged with questions about his supposed resignation. The texts were coming in response to an Outpost story published earlier that day, which reported that Providence planned to significantly reduce the availability of open heart surgery in Humboldt County in 2025. We quoted several members of the 100-plus employees who attended a staff meeting where the decision was announced. At that meeting, they said, management announced that Arcidi, the county’s only full-time open heart surgeon, planned to resign by the beginning of February and would not be replaced.

“I hadn’t resigned,” Arcidi said. “I was — and I still am — on staff at St. Joe’s. I still have my privileges. I haven’t retired; I haven’t resigned.”

However, since Providence cancelled his employment contract, there’s no longer a full-time cardiothoracic surgeon in Humboldt County. Instead, out-of-county heart surgeons (based in Santa Rosa or Napa) come to Eureka twice per month, staying for three days at a stretch. Those three-day windows are now the only times when patients can undergo non-emergency heart procedures such as stent placements, angiograms and radial artery catheterizations. And open heart surgery is not available at St. Joseph Hospital 24-7-365, as it was until a couple of months ago. 

“It’s an effective closure of the program,” Arcidi said. (Providence denies this characterization, as you’ll read below.) 

After returning to the U.S., Arcidi spoke with several people who’d attended the December staff meeting, and they confirmed what the Outpost had reported — that his supposed resignation was the reason cited for reducing the availability of open heart surgery. 

“I knew that my contract was going to be cancelled because of the need to effectively close the program,” Arcidi said. “I knew that, and I knew that it was pending. And it would have been understandable, for me, had Providence said, ‘Dr. Arcidi has done wonderful work but for financial reasons we just simply are going to have to close [the program] and try to consolidate care or regionalize care.’ But that’s not the way it happened. … Instead, it’s all on Dr. Arcidi’s shoulders.”

When Arcidi took over as director of cardiothoracic surgery in January 2021, there were 20 open-heart programs in the Providence system, stretching from Washington through Oregon and California, plus Montana and Alaska. 

“Among those, at the time I took over, Providence St. Joseph Eureka had by far the worst quality of any of ‘em,” he said. Yet he was able to achieve “an almost instantaneous turnaround” in the program, with help from what he described as a great and loyal operating room team along with great cardiology staff and physicians. 

Virtually all open heart programs in the U.S. (97 percent) have their outcomes assessed and measured by the STS (Society of Thoracic Surgeons) Adult Cardiac Database, which Arcidi called “the grandfather of all surgical databases.” During his tenure, from 2021 through 2024, the cardiac surgery program at St. Joseph Hospital maintained zero percent mortality for all STS-modeled procedures — this despite having higher-risk patients compared to the communities for other Providence open-heart programs. The local program’s morbidity (or major complications) outcomes for coronary artery bypass grafting (CABG) was the lowest (which is to say best) across the Providence system during Dr. Arcidi’s tenure.

“We went from the worst to being the first among the 20 open heart programs in Providence,” he said, adding that the Society of Thoracic Surgeons even invited him and his team to conduct a national webinar on one specific aspect of cardiac surgical perioperative care, “because our results had been so unexpected for a remote, rural community center.”

Last June, his team also presented at a cardiovascular team meeting at Stanford University, co-hosted by the California Chapter of the American College of Cardiology, he said.

Given the program’s success, Arcidi is hurt that Providence seems content to let him take the blame for the recent reduction in services. 

“To paint a narrative that was incriminating, or at least pointing the finger at me, was really disheartening,” he said. “I expected that a day or a few days after [the December news story] I would have gotten a call from either the hospital administration or someone [saying], ‘Oh, Joe, that’s not what was said’ or ‘We apologize’ or ‘That was clearly misstated.’ Nothing has ever happened.”

In fact, spokespeople for Providence have been unwilling to acknowledge any reduction of services whatsoever at St. Joseph Hospital’s open heart program. After our first story on the matter, Providence issued a statement saying the hospital would continue to offer non-emergency cardiac and vascular services 24-7-365. This statement failed to address our specific questions about the elimination of the county’s only full-time cardiothoracic surgeon position and the ensuing impacts on the availability of emergency open heart surgery. Instead it referred to its team of cardiovascular surgeons “across Northern California,” presumably referring to those based at Santa Rosa Memorial Hospital and Queen of the Valley Medical Center in Napa.

When we reached out again for comment on this story, spokesperson Steven Buck, the executive director of communication for Providence South, sent along the following statement:

We are disappointed that the Lost Coast Outpost continues to quote misinformation regarding Providence St. Joseph Hospital Eureka’s heart program. What’s most important is that the community knows that the hospital will continue to offer cardiac and vascular services 24/7/365 for our Humboldt County community.

Although Dr. Arcidi is no longer a full-time employee of Providence Medical Group, there are currently at least four other qualified cardiac surgeons who have active privileges at Providence St. Joseph Hospital Eureka and are providing the level of coverage and services which are needed for the hospital to continue fully supporting the cardiac cath lab and cardiovascular service line.

Providence assures our Humboldt community that we will continue to provide the safe, high-quality, award-winning emergent heart care they need in alignment with national certification standards.

We wrote back asking him to identify what specific misinformation we had quoted and again requesting confirmation of the dramatically reduced availability of open heart surgery in Humboldt County. Buck’s response, below, sidestepped those questions again:

It is important to understand that elective, non-urgent cardiac interventions are available based on patient need/demand. We are currently providing elective, non-urgent cardiac interventions six days per month to meet that demand. Staffing the other 24 days per month would not result in any additional patients being treated or denied care. As we continue expanding our cardiology services in the community which includes the recruitment of another dedicated full-time interventional cardiologist, the amount of cardiovascular surgeon time will be adjusted accordingly to ensure patient needs are being met.

Arcidi said the assertion that there’s still an active cardiac surgery program at St. Joseph Hospital is undercut by the fact that Providence terminated the facility’s contract with STS Adult Cardiac Database in late January. The Centers for Medicare and Medicaid Services use that database to determine payment amounts.

Even if there is technically still an open heart program at St. Joseph Hospital, Arcidi said, the limited hours have a real impact on emergency care. And he now feels reluctant to start his own practice in Humboldt County, despite the strong community connections he and his family have formed locally.

“The ability to actually perform surgery is going to be so impacted by what the hospital has done to the program,” he said.