On Wednesday evening, doctors and community members, including a couple with a newborn baby, met with the Montezuma County Hospital District board to speak about their concerns over the closure of the hospital’s birthing center among other issues regarding the hospital as a whole.
Working and retired doctors, including obstetrician/gynecologist Jessica Kaplan, attended the meeting.
The meeting began with citizen comments after some quick business items. Retired Dr. Robert Heyl, the first to address the board members, reminded them of Southwest Health System’s mission statement.
“We have retired physicians in the community who have worked in the hospital, and their offices that have some very deep concerns,” he said.
Heyl said he was becoming increasingly alarmed at the state of the hospital, and said the contract management firm in charge of the hospital is not meeting the needs of the community.
“The lack of retention and recruitment of health care providers and a high standard of health care in this community means access and continuity to providers that can deliver basic medical, surgical and obstetric care,” he said.
Heyl also suggested creating a forum where doctors and former doctors could help bring positive change to the hospital.
“Our thoughts were to have a forum, perhaps one day or more for the boards and stakeholders of health care in our community to develop plans for improvement,” he said.
“We’re not out to rehash the problems, but to help solve the problems,” he said.
Mary Dodd said the closing of the birthing center would lead to the death of the hospital as a whole.
“I particularly am concerned that once a family birthing center, which is such an integral part of the health care in this community, closes, it will lead to the closure of the hospital,” she said. “We want to work together to do everything we can to prevent that from happening.”
Dodd, chairwoman of the Montezuma County Democrats, also noted that the $40 million building the taxpayers were paying for was promised to come with the birthing center.
Dr. Eleanor Emery told the board about the increased risk of compromised health and morbidity rates in areas of the country that are “maternity care deserts” lacking maternity care.
“There’s extensive documentation in medical literature which shows that people who have to travel farther for medical care suffer negative health outcomes. That’s particularly true in maternity care deserts, which are counties that don't have access to obstetric services,” she said.
She said it’s a matter of life and death.
“A study in Louisiana showed that women were three times as likely to die as a result of not having access to accepted services in their county. So, I want to hear that the hospital board has in the financials pros and cons of closing the birthing center and that they’re factoring loss of lives in there somewhere because that's absolutely what the medical evidence shows.”
Emery also noted that losing the birthing center would make it nearly impossible to attract obstetricians/gynecologists to the area, and would most likely result in the loss of the hospital’s current doctors.
“I can’t imagine that we would be able to retain excellent doctors like Dr. Kaplan and Dr. Schmitt if we actually go through with this decision,” she said.
Retired doctors Brian and Karla Demby also addressed the board.
Brian Demby spoke of the high turnover rate in the hospital, saying they have an “OBGYN crisis and primary care crisis.”
“You’ve lost five primary care physicians from this hospital last year,” he said. “Basically, this community has hundreds of patients who now don’t have a physician, including myself, and there’s no mechanism to absorb that,” he said.
“Your board has not wanted to get their fingers dirty having to deal with managing the hospital,” he said.
“What happened here is a reflection of the way our medical care has been managed by outside companies, CEOs who come and go,” said Karla Demby. “I apologize, but I'm going to be blunt. There are people who go to another job and leave us in a shambles. And Brian and I have been here for 29 years, and I've lost track of the number of CEOs.”
Dr. Moriah Tarpey, a pediatrician, spoke of the many married couples working in the hospital, warning board members that they were at risk of losing multiple doctors if things don’t change.
“This decision affects my practice quite directly as a pediatrician,” she said. “Babies are the joy of my day, and if I don’t have a source of newborns coming into my practice, I don’t see myself staying. My husband is an internal medicine doctor … and if I go, he goes.”
Tarpey also said she wished they had known the birthing center was at risk, as she and other doctors would have tried to help come up with another solution.
“We have folks who are willing to help and want to help. We just weren’t asked,” she said. “That this was a need that was so dire that it was on the chopping block, and we weren’t aware of it.”
A mother who is in active labor can’t be transported to another hospital, and Tarpey said that leaves a laboring mother in the ER without doctors and nurses who are properly trained in childbirth.
“These are scary situations,” she said. “I’m going to have to come to the ER and resuscitate a baby who had no prenatal care.”
Kaplan echoed Tarpey, adding that she had a patient in labor as the meeting was underway, and helped deliver three babies the night before.
“Those would have been three ambulances right there just last night transporting these patients to Durango,” she said.
She pointed out that it wasn’t a matter of if something bad would happen, but a matter of when it would happen.
“These emergencies mean intervening, and seconds can save lives whether it’s a devastating hemorrhage or preeclampsia, eclampsia or a baby having a low heart rate,” she said. “You can’t wait two hours to get to another hospital to deliver that baby. This is going to be life and death.”
Joe Thomason of Community Hospital Corp. in Texas, which manages the hospital, stood to apologize to Kaplan for how the situation had been handled.
“First thing I want to do is apologize to Dr. Kaplan and Dr. Schmitt and others for the execution. That’s something that I own,” he said.
He apologized to Kaplan multiple times while addressing attendees.
“Your hospital is not in danger of closing, so I want to put that out there,” he said. “This was a preventative effort to make sure the hospital doesn’t get on that list.”
“You’ll see that half the rural hospitals in the U.S. right now are losing money,” he said. “You’ll hear, unfortunately, that some people today at the hospital lost their jobs.”
Kent Akin, a retired doctor, said, “I think the only time that I’ve seen CHC willing to engage in a dialogue or to help share possible solutions is when there’s a crisis. I think that’s part of the problem.”
Another retired doctor, Doug Bagge, told Thomason he respectfully disagreed with his sentiments that the hospital is not at risk of closure.
“You have good doctors that have been neglected,” he said, adding that if the “core” group of doctors working at the hospital now decided to leave, they would be hard-pressed to find replacements.
One member of the community, Kate Fish, said she had delivered her baby in Cortez and had experienced a high-risk pregnancy. Had she been required to travel to Durango for prenatal care, Fish said, she didn’t think she would have been able to go to enough appointments for her preeclampsia to be diagnosed.
“I firmly believe that if we did not have our OB doctors here that I may not be here. My son may not be here,” she said.
After citizen comments were completed, members of the board thanked those in attendance and said they did want to hear their comments and appreciated what they had to say.
“Having a turnout like this and hearing from doctors and folks and patients is so critical,” they said.
The Montezuma County Hospital District board is composed of Brandon Johnson, William (Bill) Thompson, Rob Dobry, Fred M. DeWitt and Orly Lucero.
The Southwest Health System Board of Directors – Shirley Jones, Susan Hodgdon, Sean Killoy and Dan Valverde – will host a meeting at Southwest Memorial Hospital’s ambulance bay on Thursday, June 15 at 6 p.m. During that time, citizens may address the board.
Those who wish to attend can RSVP by emailing lallen@swhealth.org.
