The Saga of a Hospital Closing Part 2

The minute that doctor had opened his mouth, we all knew that the opportunity for any cooperation between the Board and Staff was lost.

At that point without hesitation a member of the Board of Governors jumped up almost hitting the ceiling and very apoplectically said this meeting is over, He not only was on the board of the bank that had underwritten most of the loans to the hospital, but was also one of the political bosses in Somerset County, thus a power in the state Republican Party. His political impact would ultimately determine the fate of the Hospital.

Although there would be no future talks, the entire staff continued to use the Hospital for selected patients. For most physicians that created no problem, since our surgical patients were referred to surgeons in our primary institutions.

Soon after that episode, all four quality members of the medical executive committee resigned. Their replacements were second rate at best.

The successor Radiologist had been fired from his Philadelphia Hospital, and there were X-rays that were misread. I was reluctant to trust his reports.
The Pathologist was adequate but did not compare either in personality or person with his predecessor.

The new Chief of Staff, an internist, had been associated with one of the New Brunswick Hospital as Director of Medicine, and supposedly was not popular with its staff. He was a very bigoted individual who stated that he would never have “any foreign legion”(meaning Korean or Indian doctors) in HIS hospital.

A good community hospital had become not only an uncomfortable but also an unsafe place to practice.

After the new Chief of Staff arrived, both the Obstetrician and I were called before the Board of Governors for a hearing, prior to removing our privileges.

I thought I was innovative by appearing with my attorney and a tape recorder which we placed on the center of the table and turned it on. Initially the lawyer on their Board sputtered about the recorder, but yielded to our insisting on having a record of the meeting. The hearing was brief and terminated without action or comment.

The next day I learned that the other doctor, at his conference with them the day before, had upstaged me by appearing not only with his attorney but also with a court stenographer to record his meeting.Incidentally, we had not communicated with each other prior to the hearings

Fortunately all members of the “Volunteer Medical Staff” could admit patients to other area hospitals. Confidence in the reliable in the interpretations of X-rays was lost and the quality of some labratory procedures seemed to be diminished. Therefore, most physicians proceeded to admit all but emergency cases to their primary institution.

The patient census fell below 50%. What was never publicized was to all intents and purposes for the first time, to my knowledge; physicians had literally boycotted a hospital. No hospital can survive with an occupancy rate below 70%. (See JFK's occupancy rate in its CN application). This ultimately ended with the hospital becoming bankrupt.

There were three exceptions. When the original cardiologist left, two young internists in partnership in Warren were awarded the EKG concession. They felt they could not afford to give up the hospital. However, when the Medical School assumed the operations these two joined Muhlenberg’ staff.

One primary care physician who had had his privileges suspended or revoke at St. Peters in New Brunswick and at Somerset Hospital accounted for almost 90% of admissions after the others had independently ceased using Raritan Valley. He was acceptable to the Medical School faculty since he referred all of his in patients.

Because of, the political influence on the hospital board, the State persuaded the Rutgers Medical School to abandon its plan to build a teaching hospital adjacent to the medical school. Instead, to convert RVH into its teaching hospital, even though it could not be adequately expanded and was quite a distance from the medical school. The taxpayers had again bailed out a politician’s blunder.

Perhaps the moral of this tale. if any, lies in the fact that in this case the Chairperson of the Governing Board felt that it was his prerogative to make all decisions relating to patient care, and his Board did not honor their fiduciary responsibility.

Similarly, one can surmise that in MRC’s situation, a CEO, whose Board had forgotten that he worked for them not the reverse. has made an decision based on economics rather than community health needs in an attempt to solve financial problems which might have been aggravated by previous operational decisions.