April 13, 2006
Thanks, Duck's Market
by JUDY HODGSON
This was going to be a column about health care -- hospital care -- in Humboldt County, a follow-up to our cover story of last week, "Suits & scrubs; St. Joe's is on life support. Who's got the cure?"
First, let's be clear: It isn't just Eureka's St. Joseph Hospital in critical financial condition. It's all three of our hospitals: Redwood Memorial in Fortuna (sister hospital to St. Joe's, both private faith-based nonprofits and part of a large chain owned by Sisters of Orange in Southern California) and the private for-profit Mad River Community Hospital in Arcata. ("For profit" and "Mad River" probably shouldn't be in the same sentence. For years Mad River has been on the verge of insolvency. It's common knowledge that hospital officials are notoriously late in payments to vendors and are sometimes forced to switch vendors to obtain much needed supplies.)
The focus on St. Joe's was obvious: It is our regional hospital -- the largest -- and has specific services that the smaller hospitals do not. St. Joe's had announced the dramatic layoffs in February of a handful of its top administrators and more ominously, the plan to layoff 90 hospital workers or more, about 10 percent of its staff, by mid-May.
I was going to talk about the St. Joe's interim CEO, Joe Mark, and his ideas for managing this crisis (increased philanthropy, hospital district and tax, sale to a nonprofit or for-profit). Mark was brought on board after the Sisters of Orange executed the shakeup of the management of the Eureka hospital, which resulted in a savings of $1.4 million a year, all going to just four administrators. It was a move that needed to be made. It is unconscionable for one nonprofit institution to be paying four big-city salaries in this rural, economically challenged area. How many janitors and nurses can we hire for that amount? (Before you send me letters -- the $1.4 million plus benefits is partially offset by the cost of Mark and his turnaround team of consultants. And it did not include one-time golden parachutes.)
I was going to talk about the nurses in this column as well. I received one comment from a suit-type friend who said the article spent too much space on the nurses' point of view. "Nurses are nurturing," he said. "They're caregivers, not business people. They use the media and say `patient care will suffer' every time they want their way. The hospital is really in trouble as a business, and we have to figure out how to help the hospitals -- all three of them -- to survive." (We also talked about nurses' salaries. I love nurses, especially when I'm flat on my back and they are hovering over me, which thankfully isn't too often. But $42,000, $50,000 a year and up in Humboldt County is a very good salary, plus they get good health care for practically nothing.)
I was going to talk about my cranky friend, a retired doc, who just says he loves the sisters and that they really are on a mission from God, but the problem is they turned over the hospital management to the suits in Orange and everything went to heck after that. I was going to write about Dr. Emily Dalton's plea in the latest Humboldt-Del Norte Medical Bulletin. "St. Joseph Hospital and local physicians need each other. ... As painful as cuts may be, I'd rather have the hospital do what it takes to stay afloat than close down. We will have sick people here no matter what shape the hospital is in. We will have trauma, births, and illnesses and it will be up to us to provide treatment. We can't do that without a functioning hospital." (To which I mumbled, "Amen.")
It was clear to me after reading last week's story that we have reached a crisis point and we need to have a community dialogue soon about what we expect in health care and how we are going to pay for it. (I, personally, was thrilled a few years back when St. Joe's got a PET scanner and I didn't have to travel with my mother to San Francisco at huge expense and inconvenience. I think the cancer care now available locally is incredible and I certainly want it to be there should I ever need it.)
But on my way to write this column, I got sidetracked. When we distributed the Journal to newsracks last Wednesday, the phones started ringing. There were no newspapers at St. Joe's. That was odd. We had filled up the box that morning. So we restocked. More calls. And we restocked. More calls, this time whispering that the newspapers were being confiscated. The box was now gone. Someone was going around retrieving newspapers already in circulation at the hospital.
I called and emailed for three days but by then St. Joe's officials were firmly in their bunkers and not responding. I finally got a return call Monday morning. It was "an executive team decision." The Journal is no longer welcome at St. Joe's or Redwood Memorial. It's private property. They can decide which newspapers are welcome and which are not. We apparently frightened a patient. The hospital will continue to cooperate with media as long as they feel they are getting "fair and balanced" reporting and the Journal is not "fair and balanced." But was there anything wrong with the story? Were there errors? (No comment.)
We thought Journal readers should know the real reason for the ban: We had a spat with the hospital PR department that has been going on for more than a month. Our version goes like this: We repeatedly asked for an interview with CEO Mark in the weeks leading up to the story, the PR department said no because we neglected to come to two press conferences. We sent in questions by email. They were not answered. They were, um, lost. They were re-sent. They were not answered. Finally, we were offered a 15-minute "availability" with Mr. Mark after a press conference at the hospital Tuesday, April 4, the afternoon we were going to press. We said, no thanks. We'd been working on the story for a month and our interviews were complete.
We didn't mention any of this last week to our readers because we felt it unnecessary. The story stands on its merit. We can always do a story with or without the cooperation of a subject, although it's certainly better with. We are making this public only because St. Joe's has drawn a line in the sand and apparently favors happy news, even about a financial crisis.
Here is how institutions control the news: They call a press conference and hand out a list of "talking points" and offer to answer questions. Reporters often are not prepared so don't necessarily know what to ask. The story and photo end up on the nightly news and in the morning newspapers pretty much spoon-fed.
What I really wanted to talk about in this column was where do we go from here. There are options: For St. Joe to sell to a for-profit hospital, which is unlikely. (If a nonprofit can't make it, how can a for-profit?) Or, sell it to a nonprofit like Sutter? Or, form a community-based commission, hold hearings on hospital needs, and examine the formation a hospital district funded partially by a new tax. (My current favorite.)
In my opinion what will not work is a full-court press by St. Joseph to raise the kind of funds within this community to cover its operating losses and/or for the $80 million needed for the earthquake retrofit. The hospital's track record of expensive mistakes and mismanagement stretching back more than a decade does not warrant confidence from the community that the money wouldn't be misspent.
Let's begin a real community dialogue and see where it goes.
In the meantime, we have a new newspaper box at Duck's Market across the street from St. Joe's. Please take a handful of copies back to work with you and share them with co-workers and patients. l
Comments? Write a letter!
© Copyright 2006, North Coast Journal, Inc.