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MIA in Waltham
By Steve Bailey, Globe Columnist, 3/6/2002
If ever there were an example of why we need a plan for the state's
hospitals, it is the circus that is going on in Waltham right now.
Consider Monday afternoon's sideshow: Meeting in the office of the
developer leading the effort to save the Deaconess-Waltham Hospital,
CareGroup's top executives had come to review the findings of a critical
report on the prospects of the 116-year-old hospital. Their consultant,
the Hunter Group, gave a very downbeat assessment of the future of
the hospital to the new Waltham board of directors and the community
group trying to rescue the hospital. Then developer Roy MacDowell
and his partner in this Mission Impossible, Tufts New England Medical
Center president Thomas O'Donnell, were asked to leave the room so
the board could consider its next move.
Almost immediately, MacDowell's beeper started going off. It was reporters
from three newspapers calling for his reaction to the Hunter Group's
negative report—which each of the reporters had in hand—and
a statement from CareGroup's chief financial officer. Reaction? MacDowell
had heard an overview of the findings, but was told he could not get
a copy of the report until the next day. And what statement are you
talking about anyway, MacDowell asked?
MacDowell, O'Donnell, and their lawyer burst back into the board meeting
and all hell broke loose. You do not have to be a Harvard MBA to know
this is not the way to build trust in a business relationship.
Forget the who-did-what-to-whom fingerpointing for a minute. My question:
Why is the fate of a community's hospital being decided in a developer's
conference room?
Massachusetts has lost half of its hospitals in the past 40 years;
another 10 hospitals are in trouble. Overcrowded hospitals are closing
their emergency rooms and in-patient psychiatric beds are in short
supply. And CareGroup, in an uphill struggle to save Beth Israel Deaconess,
one of the crown jewels of Boston's medical world, is left to cut
the best deal it can with a community coalition trying to save its
own hospital?
Is there something wrong with this picture? You bet there is.
"From a public health perspective, we are all interconnected. What
happens to one hospital affects everyone in this state," says Dr.
Howard Koh, the state's commissioner of Public Health. (Koh, by the
way, got to read about the Deaconess-Waltham Hospital report in the
newspapers, too.)
Today it is Waltham; tomorrow it could be Stoughton or Needham. Yet
we lurch along from crisis to crisis with nothing resembling a plan
about what we need or how we can pay for it. "There is a lot of talk,
but not much action," says Attorney General Thomas F. Reilly.
Community hospitals rank right up there with Mom and apple pie, but
consumers have been voting with their feet in favor of the big teaching
hospitals. If we truly believe that community hospitals are worth
saving, the state is going to have to get off the bench. We need a
better early-warning system to sound the alarm before problems become
as acute as they have in Waltham. One state agency—Public Health,
for instance—should be empowered to track the data and make
it more accessible. The state can provide more in the way of special
funding for troubled hospitals and help renegotiate contracts with
insurers.
There has been a Herculean effort to save Deaconess-Waltham Hospital.
Yesterday, the numbers crunchers at Tufts New England Medical Center
were taking apart the pessimistic analysis of the hospital's prospects
prepared for CareGroup. Their bottom line: We can do better.
"We think the hospital can make several million a year after the cuts
are made," said Mark Scott, Tufts New England's chief financial officer
and a former Hunter Group employee. "It is not hard to do."
It will take a partnership between the public and private sectors
to fix what ails our hospitals. The private sector has been working
overtime in Waltham. The public sector has been notable only for its
absence.
Steve Bailey can be reached at 617.929.2902 or by email at bailey@globe.com.
This story ran on page F1 of the Boston Globe on 3/6/2002.
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