The ‘wows’ of a rural hospital
The recent controversy surrounding the dismissal of one of my colleagues from the medical staff of Holy Cross Medical Center is unfortunate and regrettable, to say the least. The suggestion by board of directors leadership that it is not the board’s responsibility to assume oversight of administration actions is confusing to me. If not them, then who does have oversight, or does the administration have carte blanche freedom to direct hospital actions? The fact that the board is currently reviewing CEO candidates and will make a decision of who is selected implies that they do have oversight. The additional comment about the hospital being a “business” is, in fact, correct, but is also why, in my opinion, the American healthcare system is in the crisis it is.
When you, as patients, are considered nothing more than a commodity — who, even before you receive care, are assigned a number and made sure you have an insurance policy — seems contrary to my Hippocratic Oath to provide care to anyone and everyone. If we are, indeed, a business, it is a unique one involving serving humans with compassion and diligence under an ethical obligation.
No, a hospital cannot function on empty finances, and I do understand that the board and administration struggle to keep staff, equipment, etc. paid for. Indeed, my paycheck, and that of hundreds of your family and friends employed by the hospital, do appreciate the fact that there are people involved in making sure funds are there. In today’s healthcare climate, this is not easy.
However, the friction that I see evolving between the people of Taos and hospital leadership is deeply disheartening. If the hospital is dismissing a highly-skilled practitioner, then does that mean other talented members of the medical staff are also vulnerable and that, to be retained, one must be silent and not raise questions about how the hospital “business” is conducted?
Having had the honor of serving as the chief of the medical staff for six years, I can truly state that the quality of care provided is superior here to that available at hospitals of similar size in rural settings. I do not want to see that lost. We need reminding, however, that physicians are human, and that means we are not always perfect, not always right, not always gracious about how we treat each other and our patients. The hope is that such indiscretions are brief and infrequent, and that the good we do far surpasses the not-so-good.
In the future, when we appeal to the community for financial support via the mill levy or simply charitable giving, memories of this discord will remain, and I fear the people of Taos will turn away with an unwillingness to extend their assistance since their voice seemingly was ignored and rejected.
There will be a temptation to seek care elsewhere. This, of course, would sadden me and my colleagues, who pride ourselves on giving excellent compassionate care right here in the community in which we live and serve. The board members are also members of this community — thus, it mystifies me that they seem to want to be dissociating themselves from it. They seem steadfast, and I admit, I am weary from trying to have them reflect on their decisions — not necessarily change them, but to find them to be less rigid and more open to discussion.
I encourage interested individuals to read a recent article from The Nation (Sept. 5), entitled “How to Kill a Rural Hospital.” It outlines the potential demise of the hospital in Gallup, and highlights hostilities between caring medical staff members, patients and hospital administrators and their boards. It mentions the firing of physicians who raised concerns about the running of the hospital and eliminating physicians from membership on the board. I believe we are not at the same level of conflict that this article summarizes — yet.
I have served this hospital and community since 2007. I originally was brought to Taos for the first time by my father in 1958 at the age of five, so I feel I have a connection to this place. Thus, I am dispirited by the conflict of these recent events, am disappointed in my hospital’s board and administration, and stressed over losing valuable colleagues and weakening the quality of our medical staff. I worry about the continued existence of our hospital.
I encourage you to remain engaged, speak out and advocate for the survival of your “community” hospital. Our “business” is taking care of you first. The ultimate “oversight” is yours and how well you trust and support this small Northern New Mexico hospital.
Dr. Tim J. Moore is Board Certified in Obstetrics and Gynecology and a Fellow in the American College of Obstetricians and Gynecologists. He received his medical degree from the University of Washington School of Medicine and completed Residency from the University of Washington Affiliated Hospitals.