As chairman of the Del Norte District of the Humboldt-Del Norte Medical Society, past trustee of the California Medical Association and the local urologist in Crescent City for the past 21 years, it is my responsibility to share with you the Medical Society's policy statement on Sutter Health's activities in our community.

This statement discusses decisions by Sutter Health and the Board of Sutter Coast Hospital to convert the hospital to a Critical Access facility, to transfer ownership of Sutter Coast out of our community and into a Sutter-controlled corporation in San Francisco and to end local authority over hospital governance, including patient care policies and physician credentialing.- Mark H. Davis, M.D., North Coast Urology

Since its founding in 1886, the Humboldt-Del Norte County Medical Society has been a voice for physicians and their patients in the rural communities of northwest California. The Medical Society is aware of ongoing controversial efforts by Sutter Health Corporation to restructure the governance of Sutter Coast Hospital and to convert it to a Critical Access hospital. Serious concerns have been raised should Sutter Health follow through with its plans.

The board of Sutter Coast Hospital has voted to accept a "regionalization" plan imposed by Sutter Health through which the hospital would fully merge into the Sutter Health West Bay Region. The local hospital board would cede all governing authority over Sutter Coast to a regional board that sits roughly 350 miles away in San Francisco and oversees approximately 14 other health care facilities, all in the Bay Area.

Physicians, civic leaders and local citizens have expressed opposition to "regionalization" and feel the local hospital board made its decision without adequate input from Sutter Coast's medical staff and community stakeholders. It is also believed that the local hospital board and other proponents of regionalization do not fully understand or appreciate the consequences of giving up responsibility to oversee the hospital and the importance of local control over governance issues that affect the medical staff, such as oversight authority on peer review, privileging and medical staff bylaws.

Independent review of the regionalization plan has also raised red flags. An attorney retained by the medical staff at Sutter Coast determined that regionalization would improperly usurp the rights and duties of the medical staff and interfere with its right of self-governance. Similarly, an attorney with the California Medical Association expressed the opinion that the plan to regionalize Sutter Coast Hospital has serious potential to upset the proper balance between the medical staff and the hospital governing board.

Strong local opposition forced Sutter Health to put its restructuring plans on hold, but the hospital corporation continues to push for final implementation of its regionalization plan.

Sutter Health's efforts to restructure Sutter Coast also have triggered a lawsuit by Beverly Hussey, whose late husband donated the land on which the hospital sits to the county in 1988 for use as an acute care hospital. Mrs. Hussey's lawsuit claims that Sutter Health's desire to convert Sutter Coast to a Critical Access hospital violates the conditions of her husband's gift and would have a negative impact on the availability and accessibility of medical care at the hospital.

The county medical society, along with the California Medical Association backed by California law, strongly believe that governance over Sutter Coast must prioritize local medical staff self-governance and ensure adequate access to the highest possible level of medical care. The citizens of Del Norte County deserve nothing less. Sutter Health therefore must respect and fully address the serious concerns that have been raised by local physicians and citizens, who are legitimately questioning the wisdom and legality of Sutter Health's efforts to regionalize Sutter Coast and turn it into a Critical Access hospital.

John Mastroni, M.D., and John Nelson, M.D., are president and president-elect, respectively, of Humboldt-Del Norte County Medical Society.