Shore Health Does Not Want Chestertown Hospital to Fail by Ken Kozel

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I always hesitate to give credibility and repetition to untruths and innuendos that appear in personal opinion letters to the editor. However, the misinformation shared in a September 6 letter by Mrs. Elsberg to the KENT COUNTY NEWS cannot be ignored.

Before I correct her misinformation, I do want to thank Mrs. Elsberg – representing herself and Save Our Hospital – for her recognition and support for replacing Easton’s aged hospital as a long overdue priority in our region. I will also reiterate to the Chestertown community, despite rumors to the contrary, there is no correlation between the timeline for Easton’s new hospital opening with decisions related to hospital operations in Chestertown. Our commitment, as consistently stated publicly, is to maintain acute care hospital services in Chestertown. Now, in response to each area of misinformation in the September 6 letter, I will provide the facts:

How We Provide Patient Care

It is unfortunate that some residents of Chestertown think that UM Shore Regional Health wants the hospital in Chestertown to fail. To the contrary, we work daily to strengthen UM SMC-Chestertown and work to ensure its long term survival as a place of quality health care for the community. To that end, there is no “policy” or “directive” from me, from UMMS or from anyone else to reduce UM Shore Medical Center at Chestertown to a “skeleton,” as the September 6 letter alleges. As the CEO, neither I nor my executive team directs patient care. The physicians and providers who care for our patients direct when, how and where they receive their care. Our medical staff bases their decisions on the clinical needs and personal desires of our patients. They help to ensure every patient, at every location we manage, gets the highest quality care in the most appropriate setting.

Our goal is to have patients receive their care as close to home as possible. When that care must be rendered outside the immediate community, we strive to ensure as smooth patient transfer to a higher level of care. When rumors and accusations of inappropriate or unnecessary transfers began to spread recently, we spoke directly with our physicians about this concern. We asked our Emergency Department and Hospitalist physicians to review every transfer from Chestertown over the past two months for appropriateness. We then asked our physician leaders to share their findings with the independent Chestertown-based community physicians. They reported that upon their review, each transfer was deemed to be appropriate to each patient’s needs. We will continue to review all transfers and report our findings to the Chestertown physician leadership team at our regular meetings, which I attend. If any unnecessary transfer is identified, it will be reviewed directly with the providers who authorized the transfer.

There is a secondary accusation in the Letter to the Editor that insists the “reason” for transfers out of Chestertown hospital is purely to boost inpatient volumes at Easton. This statement is inaccurate as well. Data shows that of the patients transferred from Chestertown to other locations of care, approximately only one-fourth are transferred to the hospital in Easton. About one-fourth of patients are transferred to mental health and addictions facilities, one-fourth go to skilled nursing facilities and approximately one-fourth go to Anne Arundel Medical Center. There is a small transfer number to other facilities from time to time – Christiana Medical Center, University of Maryland Medical Center, Johns Hopkins Hospital and the like. Clearly, the allegation that transfers out of Chestertown are directed to boost Easton’s inpatient volume is simply untrue.

If you are well versed on the future vision of healthcare in our country and state, you know that hospitals and physicians together have every responsibility to use the vast array of provider and community resources available to keep people in our communities healthy, and to use the expensive resources of the hospital only when necessary. Our mantra is the same, hospital or physician, national, state or local: provide the right care, at the right place, at the right time. Our health system’s responsibility is to have the right sized patient care facilities to meet community needs and to ensure we have the right mix of providers and services to help people stay healthier in their communities.

Physician Recruitment

UM Shore Regional Health works hard to attract new physicians and providers to this region. Attracting new physicians and providers to the Eastern Shore is a significant challenge. The lifestyle isn’t for everyone. The sparse population does not use primary care as it should, making it difficult for primary care physicians to succeed in balancing income and ever rising expenses. Compound this with lower insurance reimbursement rates in Maryland and specifically, on the Eastern Shore, for all types of health care providers, and you have a recruitment nightmare. The typical solution today, for both private practice physicians and new graduates from medical school, is to seek employment from the local health care system. Costs, including recruitment fees, salaries and benefits, overhead expenses and malpractice coverage results in six figure investments for each new provider by the hospital.

Once a candidate interviews with our system and an offer is made, the offer is usually one of several employment offers each candidate gets to choose from. Decisions are based on the physician and family’s choice – which community, will he or she join an existing group of like specialists, what are the hospital call coverage responsibilities, are their jobs for their spouse, what caliber of schools are available and how vibrant is the community for non-work enjoyment? We want our physicians to be successful, contented, and engaged members of the community for as long as possible, going so far as to recruit the best candidates before they have even completed residencies and fellowships. We don’t put candidates “on hold.” We ensure the need exists, the timing is right for our established providers and we can support their start up and efforts to grow. Their success is our success, so we want to do it right.

Even with these incredible challenges, we have successfully added providers to the Chestertown community with specialties in areas of: primary care, cardiology, ENT, pulmonology, neurology, women’s health (OB/GYN) and women’s urology. We are also actively recruiting more providers in primary care, our emergency department and within our hospitalist group. We are now also searching for a general surgeon to fill a recent vacancy. Challenging, yes, but we will persevere.

Our Team Members

Our nearly 2500 team members through the region are the heart and soul of this organization. Even when it is financially challenging to do so, we work to enhance pay and benefits for our staff and their families. Sometimes, as we are trying to adjust to this new world of health care – with its unpredictable surges, peaks and troughs in patient numbers – we have to ask our team members to adjust their work schedules as well.

As for five “veteran nurses just quit”, this is simply untrue. Three highly skilled nurses took opportunities within our system to advance in their profession, to practice at the top of their license in fields of nursing where they have special interest and desire to learn and experience more. That looks like success to us and we are very proud of them. And, when a registered dietician at Chestertown decided to retire from full time practice, we took the opportunity to EXPAND, not eliminate, the services for our cardiac, diabetic and other patients by retaining registered dietician expertise in the community and by adding the services of a part time fully certified diabetes educator.

Creating a Meaningful Future for Kent County’s Health Care

A meaningful future for health care in Kent County is the goal of us all – UM Shore Regional Health, Save Our Hospital, Mrs. Elsberg, our physicians and providers, team members, and the community. As we strive to realize our vision of being the region’s leader in patient centered health care, we know we have to provide the services and patient experience that will instill the trust and confidence needed for our community to use our hospital and healthcare services. But we, the health system, cannot do this alone. We take several steps backwards when we spend time addressing untruths like those contained in the September 6 letter to the editor because it does nothing more than add fear, mistrust and anger between all of us who share a common vision of high quality, safe heath care close to home. I truly believe that by working together, we will achieve success, much easier, faster and with the collective best interests of our community at heart.

Ken Kozel
CEO, UM Shore Regional Health

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