Kudos for recent Labor and Delivery forum

Thank you, Dr. Robin Serrahn and Dr. Zoe Berna, for hosting the OB Forum on Friday, Jan 3. True, you didn’t temper my prior skepticism, especially since promised “alternatives to the status quo” were conspicuous by their absence. Yet overall there were positives and negatives. Dr. Serrahn’s opening was on point, if lacking new information, yet addressed the big picture and the complexities around birthing.

What first struck me was the failure to offer comparable rural California hospitals to show how we cut OB (Dr. Serrahn’s position) and thrive. At times closing services guts overall cash flow and revenue, increasing a hospital’s vulnerability. We need pertinent evidence this “magic bullet” works, if only to qualify the oversimplifications pitched by local doom and gloomers: “it’s OB or the hospital.”

Dr. Serrahn’s Canada study was refuted because few found it relevant to our district. Above all, no analysis challenged this established medical model: the longer the travel time between mothers in labor and full hospital services, the greater the liferisk to both mother and child. Complications arise one-third of the time, thus top maternity docs endorse a 30-minute doorto-door threshold.

Despite email pledges, having no real “alternative” plans surprised me since for years partisans demonize OB as our most dumpable culprit. Because the CFO wasn’t present to offset Dr. Serrahn’s admitted weakness — unpacking financials — public understanding did not advance, especially on the all-important variable: monthly finances. Not having Mendocino Coast Clinic’s Lucresha Renteria on the panel (the tireless, pivotal coast executive working on birthing) left a gaping hole in the discussion. That made for predictable results: both sides restated welltrod positions. Plus, CEO Wayne Allen distorted the discussion by ignoring OB referral revenue that boosts lab, imaging, pharmacy, surgery, and pediatric/ clinic business. Wayne further muddied the waters with funny math, weirdly alleging OB’s $2 million annual loss constitutes “80 percent” of the projected $4 million loss.

Such high-level blunders undermine community confidence in MCDH and drive patients over the hill. Research confirms that mothers stay loyal to their delivery hospital and doctors, with years of post-birth patronage. The ultimate costs for ending OB thus surpass all monthly profit/ loss vacillations. Dr. Serrahn upping OB-related skill-sets is admirable, but why not insist (vs. merely “encouraging”) his ER staff upgrade its expertise? In December, the Adventist/Willits head nurse was far more reassuring, stating its ER staff anticipates problem pregnancies, with an OB/GYN doctor on tap.

Why didn’t this doctors’ forum provide comparable assurances? That you hardly mentioned Adventist or affiliation was equally odd, considering the Term Sheet sets a two-year window for all services.

All this takes nothing from forum benefits, especially that rare opportunity for four board directors to hear extended, often heartfelt presentations. More than two-thirds by my rough count urged everyone to come together and find ways to keep labor and delivery local. Mercifully, few voices pushed the “dump OB or the hospital goes” stance that John Allison, Drs. Kevin and William Miller intone with tiresome regularity.

Also praiseworthy was Dr. Serrahn’s openness to answering questions, producing superior exchanges vs. frustrating board meetings. Incidentally, why wasn’t it clarified that this gathering reflected only the Medical Staff Executive Committee, that all doctors had neither voted on this forum nor ending OB?

All in all, my critical reservations aside, thanks for organizing what turned out beneficial. Standing-room only (despite rushed notices) spoke to massive North Coast dread about OB’s future status — and what not having it means. Next time, book a larger auditorium.

Robert Becker is vice-chair of the Measure C Taxpayers Oversight Committee. All opinions are his own, not the committee’s.