Neighborhood rivals

That would have been fine with McIntyre except for one thing: Partners also has formed a grass-roots group to prevent Beverly Hospital from opening a radiation treatment center of its own. Partners executives are arguing that Beverly’s $10 million project would lead to “unnecessary duplication of a very expensive service,’’ in part because it would be located only 5 miles from Partners’ new facility.

“I’m not surprised, but it does seem self-serving,’’ said McIntyre, who said he can no longer get access to Partners computer records for his patients who get radiation treatment there. “I think they’re banking on getting the [cancer] business on the North Shore.’’

The battle over the expansion of Boston’s teaching hospitals into the suburbs has reached a new intensity since Partners opened its $144 million outpatient center in Danvers on June 1.

The Mass. General/North Shore Center for Outpatient Care, which offers radiation treatment for cancer along with day surgery and other services, brings Partners HealthCare into a community where Beverly Hospital has historically treated most patients. And it opens less than two years after Beverly opened its own outpatient center in the same community 25 miles north of Boston.

In a separate fight, meanwhile, Partners last week abandoned plans to build an outpatient surgery center in Framingham amid complaints from local officials that the facility would damage the local hospital, MetroWest Medical Center.

Officials at Partners, the state’s largest healthcare provider, argue that they are simply building an integrated system that offers greater convenience for their patients who live in the suburbs. Initially, at least, virtually all the cancer patients receiving treatment in Danvers were already being treated by Partners doctors, mainly in Boston or affiliated with Partners’ North Shore Medical Center in Salem and Lynn.

The Danvers facility “is just a logical extension of caring for these communities that we’ve been doing for a long time,’’ said Pam Lawrence, senior vice president of communications for North Shore Medical Center. She declined to comment further on Partners’ efforts to derail Beverly’s plans to offer radiation therapy to cancer patients.

Leaders in Beverly, where Beverly Hospital is the largest employer, fear that Partners is trying to expand at the expense of one of the state’s stronger community hospitals. Beverly Hospital, owned by Northeast Hospital Corp., used to be closely allied with Partners, but the two sides had a public falling out in 2006 over Beverly’s increasingly close relations with non-Partners teaching hospitals. Today, Beverly Hospital faces “unfair, predatory competition’’ from the much-larger Partners, according to Beverly City Councilor Patricia Grimes.

In Framingham, the Board of Health had asked the state to investigate Partners’ plans for a new ambulatory surgery center near MetroWest, the main provider of emergency services for the town.

“I’d like the state to inquire why it is that Partners is so determined to move into Framingham,’’ said Mike Hugo, chairman of the Framingham health board. “If it’s not to put another community hospital out of business, I don’t know what it is.’’

But, last Monday, Partners officials withdrew plans for the $17.5 million project, which had been intended to make room for the growing number of surgeries at Partners-owned Newton-Wellesley Hospital. “Our outpatient surgery center was not designed to jeopardize MetroWest Medical Center,’’ wrote Newton-Wellesley president Michael Jellinek in a statement.

Farther south, officials at Caritas Christi initially cried foul when Partners announced plans to build the Brigham and Women’s/Mass. General Health Care Center beside Gillette Stadium in Foxborough - just nine miles from Caritas Christi’s hospital in Norwood.

Former acting Caritas chief John B. Chessare called on Attorney General Martha Coakley to investigate whether Partners was improperly luring away other hospitals’ patients. Since Partners is a nonprofit organization that receives hundreds of millions of dollars in tax exemptions, Chessare argued that the attorney general should hold Partners to a higher standard than conventional businesses. At a minimum, he argued, Partners should not aggressively pursue patients who now get care at other nonprofit hospitals.

By the time Partners’ outpatient center opened in February, Chessare had been replaced by a chief executive who was originally suggested for the job by Partners’ chairman of the board. Since Dr. Ralph de la Torre took the helm, Caritas Christi has remained quiet about Partners’ expansion. A spokesman for the Catholic hospital system said that the new Foxborough facility has had no negative impact on Caritas Norwood Hospital so far.

David Williams, a consultant who has studied suburban expansion of teaching hospitals, said that Partners is drawing controversy mainly because it’s the most successful hospital system and able to afford more expansion in the midst of a deep recession. Founded by Mass. General and Brigham and Women’s Hospital in 1994, Partners has grown to eight hospitals backed by an endowment of more than $4 billion.

“They believe - and with some justification behind it - that they are a premier academically based system. It’s part of their mission to reach a broader audience,’’ said Williams, who wrote a report on teaching hospital expansion for the Massachusetts Medical Society. Partners, he said, is doing “what most people would do in their shoes.’’

Other teaching hospitals also have expanded into the suburbs, both through new facilities and alliances with local hospitals. Beth Israel Deaconess Medical Center, the second-largest teaching hospital company, has emerged as Partners’ main rival, drawing closer to both MetroWest Medical Center and Beverly Hospital as their competition with Partners intensified. As a result, the community hospitals get access to top specialists from Beth Israel, while Beth Israel gets more referrals of patients who need higher level treatment than community hospitals can deliver.

Beth Israel also has resorted to some of the same hardball tactics for which Beverly officials criticize Partners. Beth Israel set up a taxpayer group in 2006 to oppose a proposed $13 million cancer center at Newton-Wellesley Hospital, in part because it would be less than 5 miles from a Beth Israel cancer center. Beth Israel later dropped its opposition in a settlement whose terms were not disclosed.

Paul Dreyer, state director of Health Care Safety and Quality, said hospitals commonly set up independent taxpayer organizations as a way to oppose other hospitals’ building plans. That’s because a grass-roots group with as few as 10 members can force a public hearing under state law.

However, the fighting between Beverly Hospital and Partners is in a class of its own, a case study in the hazards of unbridled competition. Fifteen years ago, it’s unlikely that the two systems could have built similar outpatient centers within a few miles of each other at the same time. Since then, the Legislature drastically scaled back the Department of Public Health’s oversight of hospital expansion and neither Danvers facility required state approval at all, putting the two systems on a collision course.

In 2008, the Legislature gave the department veto power over outpatient centers valued at $25 million or more, but that was too late to prevent the dueling developments in Danvers valued together at $174 million. Now, the question is whether the area can sustain both.

Meanwhile, the split between Beverly Hospital and Partners - which began in 2005 in a dispute over whether Partners was providing enough specialist support to Beverly - has threatened to affect patients. McIntyre and a second Beverly Hospital cancer specialist had continued to practice part-time at Partners’ cancer center in Peabody even after Partners removed Beverly doctors from its physician network, largely to care for patients who were getting their radiation treatment there.

But, when Partners moved its cancer center into the new Danvers facility, officials from Mass. General Hospital said they wanted oncologists to work at least three days a week in Danvers, McIntyre said. That would have compromised his ability to keep his Beverly Hospital schedule, so he didn’t apply for credentials at the new facility. Since March 1, McIntyre said, he has not worked at the Partners center, requiring his patients getting radiation treatment there to make an extra trip to one of his other offices in Beverly or Gloucester if they want to stay with him.

No one’s been hurt, but “it was quite a disruption for our patients,’’ said Pauline Pike, chief operating officer for Northeast Hospital Corp.

North Shore spokeswoman Lawrence said that Beverly doctors can - and do - continue to send patients to Partners for radiation treatment. She also said that no Beverly doctors applied for credentials at Partners’ new center, so no one was turned down.

At a June 1 hearing on Beverly’s proposal to offer radiation therapy, Beverly officials showed their support, while criticizing Partners’ opposition. Partners’ taxpayer group did not attend. However, their written comments noted that Partners as well as two other nearby hospitals already have the equipment necessary to create a beam of radiation for cancer treatment. As a result, Partners argued, Beverly’s proposal is unnecessary.

State Representative Mary Grant of Bedford, cochair of the legislative Health Care Finance Committee, said at the hearing that she was surprised that Partners would try to block radiation treatment at Beverly after making it difficult for Beverly doctors to use their facilities.

“Why have a business plan that disrupts other people’s stability?’’ she asked in an interview, referring to Partners’ expansion program.

So far, the Partners expansion in Danvers is going smoothly, Lawrence said, and there’s plenty of room to grow. The state Public Health Council is expected to rule by August on whether Beverly Hospital can get into the radiation treatment business.

Scott Allen can be reached at allen@globe.com.