The following article that I wrote was published in Medical Economics a few years ago. For those readers who feel that I am too critical of Henry County Memorial Hospital, this explains the foundation of my viewpoint. I have since found out about more shenannigans that the current and past administrations have been a part of as well as also personally being the subject of prejudicial treatment by my tax supported county hospital. More details to folow.
“Wish I didn’t know now what I didn’t know then.” Bob Seger 1980.
Thirty five years ago I believed in Santa Claus. Twenty-five years ago I believed in U.F.O.s. Fifteen years ago I believed that only bad doctors get sued.
Ten years ago I believed the following:
A community hospital is there to benefit the community, to serve the health care needs of those citizens, and to facilitate the access of patients to the community resources which best meet their health care needs.
I no longer believe any of those things.
In March, 1993 I arrived in New Castle, Indiana. I was recruited during my
residency by the community hospital to provide family physician services in their
community. I could join an existing group or the administration would use their financial and practice management assistance in setting me up in solo practice. It didn’t matter to them. The community needed more family physicians.
Those were exciting times. I chose to join the group and I was finally a real doctor in a real town taking care of real people. There were frustrations to be sure but overall it was a nice start to a rewarding career as a small town family doctor.
Not being a partner, I guess I shouldn’t have been surprised to find out through the grapevine that negotiations were under way for the hospital to buy out the practice in early 1996. Apparently the practice was not fiscally sound and was not going to be able to meet an upcoming financial obligation.
The hospital administration realized the importance of keeping family physicians in the community. They negotiated to buy the practice with the four partners working off their debt in a matter similar to the loan repayment program that the hospital had provided me.
My original contract was worded that as long as I remained a practicing physician in the community, the loan would continue to be repaid. My family liked the town, and I liked practicing medicine there. I had learned over the prior three years that I preferred autonomy and didn’t particularly play well with others.
Here was an opportunity, thrust upon me as it were, to start a solo practice. I already had an established practice and colleagues to help with coverage. All I needed was some financial assistance and practice management know-how to get started.
I figured I need look no further than the hospital. Just three short years ago the administration aggressively recruited me to help the community with the physician shortage which still existed. Surely a community hospital would do all it could to retain a Family Physician that wanted to remain in the community providing healthcare to citizens of the community. No problem.
Problem. I was given the option of signing a multi-year contract to work for the hospital or..... nothing. There was no other option. Staying with the group for six months while I made arrangements to secure my financial and practice management assistance elsewhere was not an option according to the administration.
Well, I wasn’t going to sign on a long term contract with the hospital and I wanted to stay in this town. I didn’t have any savings to live off of while I started a solo practice from scratch, so I became a moonlighter. I commuted out of town to an E.R., three urgent care centers, and served as a company physician.
I did this for nine long months while I educated myself in practice management, while I went to six different banks to finally get approved for a loan, and that only after jointly applying through the Small Business Administration, and while I tried to convince myself that my community was worth this stress. One lender was honest enough to tell me that since his bank did business with the hospital, they wouldn’t loan me the money for fear of alienating the community hospital.
Despite knowing of my plans, the hospital owned group would tell my previous patients that I had just up and left town and that they should see one of the groups other doctors. A four week wait wasn’t all that long to see a doctor for a problem, was it?
I opened in April of 1997. A solo family practice doctor with walk-in availability open seven days a week 1 to 7 p.m.. Letting bygones be bygones, I invited the hospital administration to the open house. No one came.
I still admit patients to the hospital, I still see patients at the nursing homes, I still serve as the doctor for the county jail. I still try to do what’s best for my patients which happen to live in my community which happens to have a hospital which happens to be a non-profit, community funded hospital.
Over the last six plus years I have re-learned the definition of a community
hospital is a hospital that is located in a community it is not a hospital that exists for the community.
