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