St. John's quashes rumors over closing of its birthing center

Friday, December 4, 2009
St. John's Hospital -- Berryville will recruit to add obstetrical physicians to its staff.

BERRYVILLE -- Rumors regarding the discontinuation of the birthing center at St. John's Hospital -- Berryville are untrue, confirmed President Kristy Estrem, who said it was an option considered by the hospital's board of directors -- but abandoned after careful review.

"The board voted to continue obstetrical and gynecological services despite concerns over physician recruitment and ongoing economic challenges," she said.

Physician recruitment is being actively pursued, she said, to lessen the burden on St. John's current OB staff, which consists of Dr. Michael Marvin, Dr. John Nash and Certified Nurse Midwife Anita Rissler.

She said Dr. Marvin "may discontinue his obstetrics practice, which leaves one man standing -- Dr. Nash, and that's not a reasonable expectation of him."

She said members of the hospital's board of directors found themselves at a crossroads -- should they find more staff to deliver babies, or abandon the service, which in a rural market rarely finds itself profitable.

She said the board sought input through strategic planning from physicians, staff and management and came to the conclusion that they wanted to make it work.

The recruitment of family practice obstetrical physicians is one step the board is taking to make it work, she said.

"Rural physicians' recruitment and retainment has traditionally been a challenge for hospitals and rural communities," she said.

"According to the University of North Carolina Center for Rural Health, although 22.5 percent of the population in the United States resides in non-metropolitan areas, only 13.2 percent of physicians practice in these areas."

There is also a change in the delivery of health care, she said. The trend in metro areas, she explained, is for woman to receive their prenatal care from a primary physician or mid-level provider such as a nurse practitioner and then have their baby delivered by a hospital staffer specifically employed for that purpose. They may never meet the delivery doctor before the big day comes, she said.

The second step toward retaining the birthing center is to secure community support and feedback, Estrem said.

St. John's birthing center is "one of the most modern and prettiest," she said, with caring, competent staff and compassionate physicians, plus a certified nurse midwife to offer natural births in a home-like setting.

"A lot of women are traveling out of town to have their babies," she said. "We have to find out whey they are not using our service."

Estrem said a focus group is being established to find out why women are traveling out of town for their OB care.

"We have to have community support and feedback," she explained, "so we can figure out what we need to do to make women choose us -- and help us keep this service going. The best delivery is that which is delivered closest to home."

Despite the challenges, she said, the board is proceeding with its plan to recruit additional physicians to keep the birthing center operational.

"It was a consideration to place a pause on obstetrics," she noted, "but the board felt it would send the wrong message to the community and they realized the importance having this service means to the women in this community.

"It was an emotional decision not based solely on finances, but rather on how to best fulfill the mission of Mercy in this community. Delivering babies -- that's where the care begins."

Financial health

According to Estrem, the hospital now shows good financial health with four consecutive months of improved financial performance and a three percent operating margin.

"This follows despite a tough fiscal year that ended June 30," she said. "We were faced with making some really difficult decisions and had to make operational changes to position ourselves for the future. Most all companies in the United States have had to make adjustments given the condition of our economy."

She said some of the efforts initiated to lessen expenditures included:

* Adjustment of staff hours to match lower volumes;

* Postponing non-critical capital spending; and,

* Reduction of discretionary spending in areas that do not affect patient care, such as travel and cash sponsorships.

Estrem said she is disappointed they had to cut back on cash sponsorships for community projects.

"We've helped by sponsoring in other ways," she said, "Last year, we contributed in excess of $150,000 through our in-kind services to the community."

Those included free physicals to area athletes, hosting hand-washing demonstrations in schools, working highway trash pick-up programs, and hosting health fairs and other health-related programs.

"We want to stay integrated in the community," she explained, "especially at a time when we've had to reduce hours and positions."

Last year, she noted, they gave out more than $1.2 million in charity care by writing off portions of bills for people who could not afford to pay based on a sliding scale.

"We also had $3.6 million in bad debt," she said, from people who wouldn't pay or wouldn't fill out a charity form.

Through it all, she said, the hospital remains committed to offering inpatient and outpatient care, along with surgical and emergency services, a full array of radiology procedures, including CT, MRI, and Nuclear Stress testing, "and other speciality services to meet the healthcare needs of the community close to home."

She said the surgical department grew by eight percent this past year and additional outreach specialists have been added in the areas of orthopedic, ophthalmology, and ear, nose and throat.

What that means, she explained, is that patients can receive needed care close to home and sleep in their own beds at night, instead of spending hours behind a windshield and restless nights in strange beds.

"More than 21,000 patients were treated as outpatients here last year, receiving chemotherapy, transfusions, disease education and other services," she said.

In the meantime, Estrem said St. John's will be consistently looking for additional physicians to build up its family practice and OB programs, and specialists "so patients don't have to travel.

"We want to take care of the whole family," she said. "We have a strong family practice team here. It's exciting when you have the momentum going. It opens up doors to build added services in the community"

The hospital is also in the process of completing a grant application to become a Level 3 provider for the new Arkansas state trauma designation system designed to improve communication and better outcomes when patients experience traumatic injury. This program is being funded by the cigarette tax imposed earlier this year.

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  • Why do people go out of town for OB/GYN services? Well, I'll tell you the reason I went out of town to have my daughter...the horrible bedside manor of Dr. Spurgin. He was rude, judgemental and condecending. All he could pick up on the doplar was KTHS and told me I must have a fetal demise because he couldn't find a heartbeat. No empathy, nothing. Then made me wait over 24 hours for a sonagram to determine one way or the other. I was an emotional wreck and he didn't care. It was the worse experience of my entire life. I told him that he would never touch me nor would anyone in that clinic or hospital. I went to St Mary's and had the best experience EVER! My 'fetal demise' is a wonderful and healthy girl! Thanks for nothing.

    -- Posted by southernbabe on Mon, Dec 7, 2009, at 7:08 PM
  • My sister-in-law and I were pregnant around the same time, me being about 10 weeks behind her. She fell and a couple days later started spotting, went in and Spurgin told her the SAME THING! The "miscarriage" she was having is now a rambuctious 3 year old that couldn't be healthier!Her fiasco at St. Johns is why I went out of town (fayetteville, to be specific) to have my youngest son.

    One other factor was the c-section cut they perform at St. Johns, since I have to have a c-section. They do a vertical cut here, and from what I've heard, are pretty ugly when they are healed, so I wanted to go to someone who would do what they call a "bikini cut" and my c-section scar is barely noticable.

    I would rather try to have a baby on my own, on the way out of town, then go to St. Johns.

    -- Posted by amy0323 on Mon, Dec 7, 2009, at 8:37 PM
  • I had my child at St Johns, emergency c-section and it was done with a "bikini cut" incision. To say everyone gets a vertical cut is misleading and false. Please provide some statistics if your going to make a blanket statement that everyone gets a vertical incision. In reality, a clasic incision is made only when life of the mom or baby is in question. Im sure those few women who had to have a clasic incision to save their babys life, does not mind the consequences of the vertical incision. I am sorry for anyone who receives bad news. I pray for them to have forgiveness in their heart. We are all human and make poor choices at times. By the way, Dr Spurgin has not done babies in a long time at Berryville OB dept,.

    -- Posted by ARKCOWGIRL on Tue, Dec 8, 2009, at 8:34 AM
  • Dr. Spurgin may be "done with babies" in Berryville, but he is a huge reason why several women I know chose to go out of town to find an OB/GYN. It only takes a moment to make a reputation and a lifetime to change it. It sounds like maybe Kristie needs to do some damage control for the past harms done by Spurgin and others like him that have run the local women out of the county for health care.

    -- Posted by southernbabe on Wed, Dec 9, 2009, at 6:57 PM
  • I live in Bella Vista, and I personally chose to drive over an hour just to use the birthing center in Berryville, along with Anita Rissler as our midwife. We absolutely love the staff at the clinic and in the birthing center, as well as the amenities the hospital provides! In our opinion they are filling a great need in our community by supporting a natural view of labor and childbirth. Our experience with the hospital, clinic, physicians, and staff were nothing but positive--including being able to be seen early in my pregnancy due to previous miscarriages, when all the other clinics wouldn't give me the time of day until 12 weeks. Thank you St. Johns--Berryville, and thank you Anita! We would do it again in a heartbeat and recommend them to everyone we know. We're so glad they are staying open!

    -- Posted by chelynn on Fri, Dec 11, 2009, at 2:34 AM
  • Dr. Spurgin was wonderful when I found out I was pregnant and gave me options on where to go. I decided to go to Fayetteville. I miscarried and he handled my after care and was great. I got pregnant again and went to Fayetteville mainly because he considered me high risk and Tyson's insurance has a wonderful package if you go over there.

    -- Posted by gfresident on Fri, Dec 11, 2009, at 5:03 PM
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