Moving forward with baby steps

By Published by The Editorial Board

Published: November 9, 2008

To the editor:

I read, “A problem we can’t ignore,” (Oct. 19, page A11) with great interest. I am one of the new physicians who have been recruited to Danville Regional Medical Center. I came here not because I needed a job, but because I felt that this facility was a diamond in the rough with many good people who want to see this hospital succeed, a good subspecialty base — which is unusual for a hospital and community of this size — and the desire to be a highly functioning provider of health care.

If one looks at the evolution or deterioration of this facility depending on your point of view, it had many issues before LifePoint got involved. Last time I checked, LifePoint wasn’t out buying high-performing facilities, but rather hospitals that are usually the sole provider in their market with financial or other performance issues of which this facility had prior to LifePoint. Their mission is to develop facilities that provide high quality health care in areas that aren’t overserved.  I am sure I don’t need to remind you that health care has become quite competitive thanks to our government that condoned the third-party payer system among other issues. This has essentially changed the system into a profit-based business model.  I can assure you the only difference between the Moses Cone Health System or any nonprofit health provider and Danville Regional Medical Center as a for-profit entity is the fact that Danville Regional Medical Center now supports the local tax base to the tune of about $13 million per year, but all of the other issues to reduce costs, provide high quality care, decrease length of stay and operate to maximize the bottom line is the same.

Why do you think other health care providers are marketing to the people in Danville? Like any other business, they are constantly looking for new sources of revenue and they are preying on the fears and misinformation that is generated by articles which are based on emotion and not necessarily fact.

Having said that, I recognize LifePoint came into this facility without understanding its inner workings and essentially decimated the already tenuous infrastructure. I do feel strongly that this was not the intention but more due to the fact that it was not recognized by the powers that be how tenuous the infrastructure was, how little standardization and process were in place. It took just a few of the middle management to leave and the whole house of cards began to tumble because the processes relied on specific people, not on standards and process. Couple that with the deep emotion, lack of communication and the media heyday and you have disaster.

The publicly reported data to which you refer does not revolve around adequate staffing but rigid standardization of care and documentation. The details of the core measure performance and data collection and analysis are beyond the scope of this article but suffice it to say your assumption is incorrect and inflammatory.

Around the region and indeed the country, hospitalists are now the standard and not the exception. There are few hospitals that have not established or are in the process of establishing a hospital medicine department. Hospitalists are doctors who focus their practice of medicine on the hospital patient. They are graduates of accredited medical schools and residency programs who are licensed physicians. In this case, as in many others, the hospitalists at Danville Regional are employed by the hospital. I am paid by Danville Regional to provide high quality and compassionate medical care to the people who come to this facility regardless of their ability to pay. I am not paid to promote LifePoint.

Primary care providers everywhere are in short supply. The economics of attempting to provide care in the office and the hospital are not favorable for the traditional model of medicine as many of us have known it. I don’t foresee that it will change anytime soon neither here or anywhere else in the United States. Annie Penn, Moses Cone, Morehead, Duke, UVA and North Carolina Baptist all have hospitalists and that is who will provide your inpatient care should you need to be hospitalized.

Recreating the old Danville Regional Medical Center is unlikely to be in the best interests of the community, but moving forward in tedious but necessary baby steps is how we must progress in order to create a facility that practices evidence based medicine, focuses on patient safety, utilizes our resources in an efficient and effective manner and provides the satisfaction and pride that this community deserves. An informed leadership in the community is an integral part of this process.

FRANCES DeCHURCH, M.D.

Danville

(Editor’s note: Dr. DeChurch is the program medical director at the Department of Hospital Medicine at Danville Regional Medical Center.)