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The Journal Gazette

Sunday, September 10, 2017 1:00 am

Treat Lutheran more as partner, less as child

Drs. William Cast, Matthew Sprunger and J. Philip Tyndall

There was a day when Lutheran Health Network and its parent company, Community Health Systems, worked well together.

CHS, headquartered in Tennessee, worked collaboratively with Lutheran Health's local professionals and respected its culture. CHS ran a tight ship, but CEOs like Tom Miller, Dr. Mike Schatzlein and Brian Bauer were able to preserve the interests of Lutheran Health. Lutheran Health is unique in the CHS system because it is a tertiary hospital for advanced procedures – in other words, a referral hospital – operating in a mid-sized city, whereas most of CHS' other holdings are small and rural. CHS respected that difference until it paid too much to acquire 71 Florida-based hospitals from Health Management Associates. Things changed as CHS began to carry too much debt. An austerity program was introduced at Lutheran Health – staff cuts and deferred maintenance, for example – designed to bail out CHS' bad decisions.

What's happened – somewhat predictably – as a result?

• Physicians and nurses, seeing quality diminish, rebelled against CHS.

• Local physicians made an offer to buy Lutheran Health, which was rejected.

• Local business leaders and physicians resigned their board positions with Lutheran and Dupont hospitals; doctors resigned as chief of staff, president of staff and chief information officer.

• CHS fired local physicians or forced their resignations, and more physicians have reported that CHS will not renew contracts expiring this fall. Replacements have come from outside the area, and not all are board certified.

• Standards of care, as certified by trusted health care agencies, fell. The St. Joseph Hospital Burn Center's verification with the American Burn Association, for example, is “pending” and ultimately may be lost. Also, Medicare Compare looks to downgrade Dupont from a four-star to a three-star hospital – a significant demotion.

• Recruitment of new physicians and nurses has become more difficult. Why, after all, would top-ranked physicians come to such a place?

• CHS cut ties with forward-thinking programs led by trusted physicians, like Dr. Rudy Kachmann's wellness program.

During this time, a mere 90 days, local management says things like: “I'll earn your trust,” “I now have the authority” and “I'm gaining traction.” But is it likely any of those promises will be made true, given that top business people have fled, even from local advisory boards? When physicians continue not only to be fired, but insulted? When nurses are given impossible patient loads that guarantee poor patient satisfaction and low morale? When a touted “upgrade” is paint on the walls instead of much-needed repairs to plumbing and sewer lines? When janitors can't empty trash cans before mice arrive? When CHS dictates even the purchase of plastic foam cups?

We can recall a time, not long ago, when Lutheran Health was respected and respectable because it was run by local professionals. The St. Joe Burn Center was properly verified, Dupont Hospital's four-star status was never in question, and physicians like Dr. Kachmann were seen as partners, not merely expenses. Our community is fortunate that this standard still exists at Parkview Health, which uses “Not for Profit, All for You” as its slogan. While we believe for-profit hospitals can deliver equally good care at a competitive cost, the approach at Lutheran Health appears to be “For Profit, Not for You,” as new Lutheran Health CEO Michael Poore continues to allow relentless cost-cutting, staff reductions and deferred maintenance, as mandated by CHS.

What will it take to return Lutheran Health to better days? In a phrase, deeds, not words. It is time for CHS and Lutheran Health's new leadership to show they are committed to its health care professionals. It is time for Lutheran Health to be treated as a partner, not merely a revenue generator. It is time for Community Health Systems and Lutheran Health Network to regain the community's trust. Time, however, is running out.

Drs. William Cast, Matthew Sprunger and J. Philip Tyndall are the founders of Northeast Indiana Citizens for Healthcare Excellence.