Coastal Voices: Critical Access is better than losing entire hospital

By Christopher Cutter March 07, 2014 05:37 pm

The people of Del Norte and Curry counties have been expressing a broad range of views regarding several issues surrounding Sutter Coast Hospital.

We have been hearing many valid points on both sides of this controversy and I would like to share some experiences that I have had that may be relevant, and offer my perspective on this.

I’m a family doctor and chose to leave the Los Angeles area in 2004 to try my hand at rural medicine in south Louisiana. I was on staff at a busy, full-service, rural hospital located in a town of about 4,000 people, which served a much larger geographic area.

In 2008, we were informed that the parent company of the hospital no longer wished to cover our losses and indicated it would be leaving in 18 months; thus beginning our search for another organization to support our community hospital.

As promised, ownership changed in 2009. Since that time, no less than four administrations have come and gone from that hospital in Louisiana — none of them able to make it sustainable.

As a cost-saving tool, obstetrics was cancelled and now patients have to drive 30 miles to have their babies. The pediatric department is now down to one doctor. Medical floors closed and beds were reduced drastically.

The ability to adequately care for medical patients has been challenging at best.  Most concerning, is that there is no money to recruit and support new doctors, and the existing staff is diminishing rapidly. 

Fast forward to today — in Crescent City. Sutter Health has known for some time that Sutter Coast has seen diminishing reimbursement coupled with declining volume, which has put a strain on the financial stability of one of its smallest hospitals.  However, it is not threatening to leave, despite the fact that it would be an easy out. Instead, I see it working diligently, reaching out to the community, as well as the medical staff, to partner for a stronger future. 

I personally have no doubt that the current financial picture for our hospital is bleak without transitioning to Critical Access. I have previously been a vocal and outspoken opponent to the idea of transitioning to Critical Access designation, however I now believe it is a necessary move to simply keep any hospital in this city. 

Medicine is undergoing social, political, and financial changes that I could never have imagined 33 years ago when I left UCLA School of Medicine. We now face unprecedented challenges in meeting the health care needs of those we serve.

Many in our region have little or no insurance or are on government-paid insurance — Medicare, Medi-Cal or the new Partnership programs, which typically do not cover the actual cost of care. In spite of the financial challenges, Sutter Health continues to support our local hospital. 

Critical Access status will allow us to augment our outpatient care, while continuing our high-quality inpatient care. I do not doubt there will be an increase in some medical transfers, but this is far from a new problem.

Our hospital does not have the specialists that are available at larger centers. It never has (and it never will have) those capabilities simply based on our current size.   Medical transfers have been an integral part of care in this county for years.

I have been reassured by our administration that there is no intent to reduce services such as the emergency room, obstetrics, pediatrics, ICU, outpatient surgery, our outpatient clinics, or our medical floors. This allows the same care to go on that was provided before, albeit with the reality of a 24-bed cap.

We have a wonderful hospital with top-notch doctors, nurses, mid-levels, and support staff. Excellent care is being delivered here every day.  If we were to lose our hospital, the effect on the community would be devastating.

Hospitals may be closing in other areas, but we are working hard to make sure ours is here to stay. The team at Sutter will be here to serve the residents well into the future.

I am proud to be a part of a hospital and health system that gives back so much to the community, and I intend to continue to do my part to be of service.

Dr. Christopher B. Cutter is a physician at the Sutter Coast Community Clinic.