Archived Opinion

Hospital system wants dialogue with community

By Steve Heatherly

At the April 16 Jackson County Commissioners’ meeting, a physician stated his concerns about the future of MedWest-Harris and MedWest-Swain. While some of the observations are correct, we disagree with the assertion that MedWest-Harris and MedWest-Swain have only two options in its future, failure or joining Mission Health in Asheville. 

Since the summer of 2010, members of MedWest management, CHS and some members of the MedWest-Harris and MedWest-Swain medical staff have participated in a dialogue that has resulted in changes that address concerns raised by physicians.  Specifically, a management team dedicated to operations at MedWest-Harris and MedWest-Swain was appointed in February 2012.  While no change in management structure can magically fix the challenges faced by most rural hospitals in America, and those specific challenges at MedWest-Harris and MedWest-Swain, our recent change has generated a favorable reaction by the vast majority of staff and physicians.  

As a bit of history, by 2010 Harris and Swain had experienced a four-year trend of losing market share, driven by the natural the ebb and flow of physician departures, resulting in constrained access to care within the communities we serve.  Patients increasingly began to seek care outside their local medical community. In 2008 and 2009, WestCare made a significant investment in the recruitment of more than 10 additional physicians which is likely responsible for arresting the descent of market share loss from 2010 to present. Now that we’ve had success in rebuilding our medical staff, we need more patients from our local communities using our local hospitals. Only then can we expect more positive financial results.

Our hospitals must confront the fundamental business reality that expenses cannot continue to be greater than revenue.  In the short-term, there has been rigorous evaluation of cost with a focus on ensuring that our labor expenses match our volumes.  Most position eliminations have come through attrition with the remainder coming through upward and downward flexing of staff to better match the number of patients in the hospital on any given day.  These adjustments are being made in close consultation with the Medical Staff and with our Departmental Leadership, with patient care as the centerpiece of every decision.

No organization can cut its way to prosperity, especially not a hospital, where quality patient care is our business. Thrive-ability will happen when more patients come through our doors to see our brilliant doctors and caring staff. It will happen when patients experience processes that are easy to understand and utilize. It will happen when it’s evident that our commitment to customer service can only be described as fanatical.

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At least seven new physicians are joining MedWest-Harris and MedWest-Swain in 2012. Even in this less-than-optimal economic environment, we have expanded services to our communities through newly-constructed medical office buildings in Sylva and Bryson City. MedWest-Harris opened a wide-bore MRI and the area’s first urgent care center in August 2011. In addition, we have expanded upon our partnership with Western Carolina University with a presence in its new allied health facility which will open later this year.  

We continue to seek physician input with respect to our future. Within the past two weeks, we embarked on a process with Medical Staff leaders to focus on a shared vision and strategy for Harris and Swain going forward.  I am proud to report that there was unanimity around the idea that, whatever organizational structure within which our hospitals exist, our primary focus has been and must be to take great care of patients.  That focus has created the enduring legacies of Harris and Swain and is critical to our success.

In an organization of the size and complexity of MedWest, there will be diversity of opinion regarding most any topic.  This is no doubt the case in the present circumstance.  I believe it is the intention of the more than 1,000 employees at MedWest-Harris and Swain, its Medical Staff and management to use this moment as an opportunity to synthesize our diverse perspectives into an action plan aimed at preserving our hospitals as assets for the communities they serve for generations to come.  We look forward to an ongoing dialogue with the community, through a variety of forums, as we strive to accomplish the mission of our organization to provide high quality, compassionate, local access to health care.    

(Steve Heatherly is the president of MedWest-Jackson and MedWest-Swain.)

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