Archived Opinion

Hospital affiliation may be best chance for survival

op frCount me among those who hope the MedWest affiliation between Haywood, Jackson and Swain hospitals survives. Otherwise, I fear none of the three hospitals will survive, but instead be swallowed up or severely marginalized in within a decade.

It’s been a tumultuous four years for the hospitals in the counties west of Buncombe. Despite the bumps in the road, though, there seems now at least a path — via the management contract with Carolinas HealthCare — for the three hospitals to move into the future serving pretty much the same role in their communities they’ve been serving for decades.


But by my estimation — from a healthcare, economic, and quality of life perspective — I think Haywood, Jackson and Swain counties deserve their own hospitals with their own specialists and their own medical communities. We share a lot, but each county can support its own hospital. And the best chance for that to happen is by working together.

Evidence has shown that it will be difficult for any of these small hospitals to thrive on their own. Neither Haywood or WestCare was doing particularly well prior to the MedWest affiliation. Everyone knows about the nearly catastrophic situation that came to pass in Haywood when it lost its Medicare certification and nearly all the insurance provides pulled out. It almost closed.

WestCare — an affiliation of Harris in Jackson County and Swain County Hospital — was also struggling to turn a profit. It was laying off workers and have a hard time keeping its head above water. Many of the Jackson County doctors who now want out of the MedWest affiliation have perhaps forgotten those days.

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Or perhaps they haven’t, but they just want out from any joint venture with HRMC. Looking at the series of events — Haywood loses certification, CEO David Rice resigns, new CEO Mike Poore comes in and steadies the HRMC boat, then he is named CEO over affiliated MedWest (and over WestCare) — it’s easy to see how Jackson medical professionals could feel that they have gotten the short end of the stick. On top of this, there’s the unprecedented loan from Carolinas HealthCare that was basically all about helping HRMC, not the system as a whole.

Perhaps the Jackson docs are right to be mad. But do just a small amount of research and it’s hard to find a survival scenario for a small, rural hospital out on its own. Perhaps WestCare can do it, and if the hospital board of directors votes to pull out of the affiliation, I hope it can. Jackson and Swain citizens want and deserve their own hospital.

I’m biased. Our newspaper has been covering these three counties very closely for 13 years, and I think there is a synergy in being positioned west of Buncombe County yet relatively close to each other. We have some unique, vibrant small towns, a university, two outstanding community colleges, and three counties with a combined population of around 120,000 people. On top of that, there is Qualla Boundary and its rich heritage. I think we are stronger together than separately.

And a growing number of citizens of our region don’t subscribe to the bigger is better mentality. That’s one of the reasons we live here and fight so hard for our small communities to thrive, and why we will support our local hospitals as they seek a path to success.


How much is too much?

As this issue progresses, our newspaper — and other media outlets in the area — faces its own tipping point. Eventually, editors are forced to decide whether some stories are simply getting too much ink, too much play. In almost all cases it comes down to making a judgment call as to whether readers really care enough to keep reading. In very rare cases, another factor could be that we may have information that can’t be reported but that makes us believe very strongly a particular story needs to be out there for public consumption.

The ongoing events surrounding HRMC, Harris, Swain and the MedWest affiliation are a prime example of the type story I’m talking about. How much do you want to know? How important is every nuanced twist and new nugget of information in this story that is, at its most basic level, about the kind of healthcare those of us in the region have available now and will have in the future?

Remember mom telling you to eat your vegetables, that they were good for you? Well, many of us who are the editors in the news business do the same thing: we force feed readers information we know is important (i.e., good for you) whether they like it or not.

In this case, it seems readers remain interested. Our hospital stories often end up among the most read on our website. When I go out into the community people tell me they appreciate the coverage.

Just how much have we written? I searched our archives and found 216 stories that contain “HRMC” since 2008 (the HRMC decertification occurred in February 2008); 101 stories that contain “WestCare” since 2008; and 62 stories containing “MedWest” since 2009. We’re a weekly, so that means we averaged almost one story a week with the term “MedWest” since 2008. Truth be told, some of those weeks we had three or four stories, and other weeks we did let the story drop (believe it or not).

I’d be interested to hear from readers their thoughts on our coverage of this ongoing healthcare issue.

(Scott McLeod can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..)

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