Requiem for a Community’s Hospital

How Customers Are Losing Local Healthcare Providers in Rural Communities

October 10, 2013

All over the country, larger healthcare systems are rationalizing healthcare delivery and closing down small, rural hospitals, despite the fact that there’s a special Medicare designation and funding available for what are known as “Critical Access Hospitals”—those providing emergency care, stabilization, and local treatment for minor injuries, rehabilitation and end-of-life care. This is the sad story of one peninsula’s unsuccessful fight to save its local hospital. The moral of this story: if you’re going to drastically change service delivery, you need to work cooperatively with your customers to co-design a reasonable solution.

NETTING IT OUT

(by Patricia Seybold)

A concerned citizen bids farewell to a small community’s hospital and summarizes the lessons learned. This is the second time in 15 years that Dr. Judy Stone has experienced the demise of a local community hospital. Her former practice at Memorial Hospital in Cumberland, Maryland changed drastically after the secular hospital merged with a Catholic health system,¹ ultimately leading to her closing her practice as the only Infectious Disease practitioner in a 75 mile radius.

This article is reprinted, with permission, and a few additions, from September 24, 2013, Scientific American blog.²

Requiem for a Community Hospital

On October 1st, 2013, the people in the four towns on the Boothbay, Maine peninsula lost their 105-year old hospital.

FAREWELL TO A RURAL COMMUNITY HOSPITAL

(by Dr. Judy Stone)

Requiem for a Community’s Hospital

Last night I participated in a requiem for St. Andrews Hospital in Boothbay Harbor, Maine, and for the lost innocence of rural communities. A memorial service was conducted when the door to the hospital’s Emergency entrance was closed for the first time in 105 years. I joined a group of determined protestors to hold a farewell ceremony at St. Andrews after the “Urgent Care” closed for the night on October 1, 2013. Lincoln County Healthcare’s CEO, Jim Donovan, who had denied permission for the peaceful service, could be seen occasionally peering out from inside St. Andrews, where he remained, protected by security staff, guarding the entrance to the former hospital.

HOW DID WE GET HERE?

Parent Nonprofit Announces “Change in Service”

Just over a year ago, Lincoln County Health (LCH), part of MaineHealth, announced that they would be closing St. Andrews Hospital and Emergency Room, the community’s bedrock for more than 100 years. The announcement came in the form of an article in the local newspaper as a fait accompli. There was no community involvement or discussion. The decision had already been made behind closed doors in a board meeting.

How the Community Responded

The community was justifiably outraged at this unexpected news, and the peninsula’s four towns put together a task force of selectmen to explore alternatives. A healthcare needs assessment was conducted, and legal advice was obtained. Subsequently, the Boothbay Region Health and Wellness Foundation³ was formed to continue the work of the Task Force as well as to plan for unmet health needs on the peninsula… (more)

(Download the PDF to read the entire article.)

About the Author: Judy Stone, MD is an infectious disease specialist, experienced in conducting clinical research. She is the author of Conducting Clinical Research, the essential guide to the topic. She survived 25 years in solo practice in rural Cumberland, Maryland, and is now broadening her horizons. She particularly loves writing about ethical issues, and tilting at windmills in her advocacy for social justice. As part of her overall desire to save the world when she grows up, she has become especially interested in neglected tropical diseases. When not slaving over hot patients, she can be found playing with photography, friends’ dogs, or in her garden. Follow on Twitter @drjudystone or on her website.

Endnotes

1) See http://blogs.scientificamerican.com/molecules-to-medicine/2012/08/13/hospital-merger-deja-vu/

2) See http://blogs.scientificamerican.com/molecules-to-medicine/2013/09/24/requiem-for-a-hospital/