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Wednesday, 18 April 2012 20:33

Dissension among the Jackson medical community spells trouble for MedWest

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A group of Jackson County doctors say they want out of the two-year-old partnership with the hospital in Haywood County and instead would like to look toward Mission Hospital in Asheville as a future partner.

There have been murmurings for months that Jackson County doctors are dissatisfied with the pseudo-merger with the hospital in neighboring Haywood and might want out. But this week marked the first time a group of doctors went public.

“There is a common element of frustration with day-to-day operations, and concern about the financial viability of the hospitals,” said Bob Adams, the chief hospitalist at MedWest-Harris hospital.

Adams, backed by six other doctors, appeared at the Jackson County commissioners meeting Monday to get his message out.

Though the doctors say they ardently support Harris hospital, they are dissatisfied with the MedWest joint venture that united Haywood Regional, Harris and Swain County hospitals under a single umbrella. At the same time, the new MedWest entity signed on with Carolinas HealthCare, a network of 34 hospitals based in Charlotte.

Many doctors in Jackson and Swain now say that was a mistake — and that they don’t trust Carolinas or their own board of directors.

“MedWest is failing and needs to be dissolved. Carolinas is not an acceptable partner,” Adams said. “Mission is the only partner acceptable to the communities west of Balsam.”

Some doctors in Jackson County believe Harris has not fared well in the MedWest joint venture.

Harris is struggling financially. It has seen an outmigration of patients. Doctors, too, are leaving.

Adams said he is one of eight physicians leaving Jackson and Swain counties in coming months. The community already faces a doctor shortage, a factor partly to blame for the loss of market share in recent years.

Doctors in Jackson County also feel that the Haywood hospital is being groomed to become the flagship of the MedWest venture. They fear patients once cared for locally at Harris will be gradually siphoned to Haywood. They also feel Haywood has gotten a greater share of resources. A long-promised new emergency room remains on the back burner in Jackson — meanwhile Haywood used up MedWest’s borrowing ability by taking out a $10 million line of credit to stem a cash flow shortage.

Whether real or perceived, the Jackson medical community has long prided itself on its reputation and didn’t take kindly to the thought of their beloved local institution declining. That, along with a strong independent streak, has doctors questioning the corporate relationship they now find themselves in as culturally incompatible.

“It is clear to me that the hospital that I joined 10 years ago no longer exists, and is unlikely to rise again from its current ashes,” said Dr. Waverly Green, who is leaving the community in a few months. “I am saddened that it has come to this, and ultimately, I think the community as a whole will be left paying the price.”

Adams and Green both blamed Carolinas HealthCare System as duplicitous in bringing about Harris’ plight.

Adams said he does not trust Carolinas to look out for the interests of their local Jackson County hospital.

They say Carolinas pushed Haywood and Jackson together to advance their own long terms interests — namely to mount a competitive front in WNC against Mission, Adams said

After corralling the trio of hospitals under MedWest, Carolinas then began setting the stage for Haywood to be the lead player with Harris and Swain in supporting roles.

“Carolinas wants everything to funnel past us to Haywood and stop them from going to Mission,” Green said.

“It was Haywood-centric all along,” agreed Bob Carpenter, a former board member for WestCare and MedWest.

Carpenter resigned in a show of solidarity with the medical community.

In particular, though, Carpenter believed the board had not been given ample time to consider signing off on $10 million loan documents that encumber the entire MedWest venture for money borrowed by Haywood. Carpenter said board members were called into an emergency meeting in January and asked to sign documents they had not even had a chance to read.

“They said we had to do it to save the MedWest system,” Carpenter said.

Haywood allegedly didn’t have the funds to make payroll and needed the credit immediately.

The Jackson County medical community appealed to the management of MedWest and Carolinas as well as the hospital board of directors several times during the past six months to no avail.

“I realized we were being shut out,” Green said.

Adams has worked at Harris for 36 years and does not take lightly the decision to come forward with his views.

“Some people thought it may do more harm than good and may be more destructive,” Adams said. “A group of the physicians believe the information needs to be made public and our whole intent is to allow the community to make a decision to look further into what is going on and make their own decisions.”

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