More Turbulence At Coast Hospital

After sitting through the Mendocino Coast District Hospital candidates' forum on October 6th, I promised myself I'd say something positive or at least charitable about said facility. So here's what I can say: Only one member of my immediate family has died in the Mendocino Coast District Hospital.

That may be a bit too sardonic; and, for those of you not up on your Greek, the word sardonic comes to us from a plant native to Sardinia which, the early Greeks believed, when eaten caused a person to laugh uncontrollably, right up to the moment the person died from the plant's toxicity. One other member of my family may have died prematurely because of the failure of Mendocino Coast District Hospital (MCDH) to correctly diagnose a malady. That brings the death list to 40% in my immediate family.

In all fairness, there are some very talented people working at MCDH. I can think of a phlebotomist who knows how to painlessly open a vein and make you laugh or smile every time blood is drawn. Phil Sullivan was an RN at MCDH for years who always performed both professionally and humanely. I have had two colonoscopies at MCDH and would recommend the doctor who performed them, Daniel Conlin, to anyone. However, for every positive I could cite a negative that I have first hand or extremely reliable second hand knowledge regarding. One that comes readily to mind: A breast cancer biopsy patient left alone in recovery, saved from suffocating in their own vomit due to a fortunately timed visit/intervention from a family member, not hospital staff.

I could go on, but let's return to the five candidates who spoke on October 8th. Three seats are open on MCDH's Board of Directors. The Candidates' Forum was held at Cotton Auditorium where voices echoed over a much less than half full forward section of the hall and most of those in attendance seemed to be either direct employees of the hospital or doctors with ties to MCDH. At least three Fort Bragg City Council members were present, but of the rank and file populace of the hospital district — pretty much zilch.

Mendocino Coast District Hospital is within a month or two of coming out of bankruptcy. Informed sources indicate, however, that the hospital is still spending at the same rate or more than it was when it filed for bankruptcy.

Somebody here isn't gettin' it.

So you might expect a plethora of fresh faces for the three vacant Board seats.

Wrong again.

You get one. And the one is a business consultant named Michael Carroll who appears to have far more experience consulting bookstores and writers than anything approaching the beached behemoth that is Mendocino Coast District Hospital.

The other four candidates consist of three physicians with long time ties to MCDH and a nurse turned case manager. One of those doctors, William Rohr, should look up the word arrogant in the dictionary then write a letter of apology to “arrogant” for acting more egocentric and just plain uppity than a living, breathing thing should ever do in public. Rohr is a very competent orthopedic surgeon who, at the candidates' forum, answered nearly every question tossed his way with a reference or two or three to the national foundations and corporations he has been affiliated with. Gag me with a self-indulgent resume!

Here's the problem: the arrogant egotist might be one of only two candidates who has any semblance of an idea about how to fix MCDH. The other is Dr. Peter Glusker, a more than capable neurologist so old he may have operated on the original “Nervous Nellie.”

When MCDH started sinking in debt, and possibly before, one of the first positions to suffer the ax was the all too necessary job of patient advocate. Glusker and Rohr refer to this as an ombudsman, but we're essentially talking the same lingo, someone to stand up for the consumer's rights without being beholden to the hierarchy of the hospital. Glusker and Rohr get it at that level. Two years ago Rohr called out the hospital publicly concerning problems with the sterilizer in the operating room. Arrogant or not, that takes guts. Voters should be aware that Doctors Rohr and Glusker are running as a tag team for the MCDH Board.

All of the candidates praised CEO Wayne Allen for navigating MCDH through the bankruptcy process. Each candidate who works at the hospital (all save Michael Carroll) claimed that CEO Allen had made the financial intricacies within that bankruptcy crystal clear and understandable in layman's terms. None of those four (Rohr, Glusker, anestheliogist John Kermen, nor case manager Kitty Bruning) grasped the inherent contradiction when they all answered queries about potential budget cuts with answers that added up to “we don't know what the finances are in specific departments at MCDH.” Rohr went so far as to say that after much research he'd found that MCDH finances were set up in a manner that makes it impossible to discern which services and departments are profitable and which are not.

Bruning is just mildly clueless, but perhaps most dangerous is Dr. Kermen, who has sat on this board for a number of years. His campaign platform is this: a parcel tax. Surely Kermen remembers nearly a decade back when the powers-that-then-were at MCDH tried to cram a flat $96 per parcel tax down the throats of their patients/constituents. The Board of Directors at that time didn't even grasp the inequity of charging a single, modest lot homeowner in Fort Bragg the same tax amount as someone living on a million dollar or more lot, let alone the difference between a one acre or less parcel vs. timber company parcels which are often hundreds of acres. If there is to be another run at a parcel tax, hopefully, the new Board of Directors will propose something akin to the "unit" tax that the Albion-Little River Volunteer Fire Department has on the ballot this November. In the "unit" method larger businesses such as restaurants and stores are worth many more "units" than a single family dwelling.

Listening to Kermen, one can't help but get the feeling that a parcel tax is going to solve all the financial woes at MCDH. For that to be true, the price tag for a parcel tax, even in "units," would be several times higher than the $96 parcel tax measure that failed in 2005. Interestingly, Kermen seemed to garner more applause from those in the October 6th audience who are employees of MCDH than any of the other candidates. He appears to be the darling of those who are only concerned with their jobs, regardless of the unrealistic nature of continuing expenditures at the same rate, or higher, than those that plunged MCDH into bankruptcy.

But reality is not the top card in the deck that MCDH plays with. Every candidate denounced the statewide ballot measure that calls for drug testing of physicians. The doctor and nurse candidates cited peer review policies that they said already worked well.

That is utter BS, to put it mildly. Over the last 20 years MCDH has dragged its heels every time doctors have had "problems." If doctors were dismissed, it was only after patients or patients’ families vehemently complained. And problems with MCDH staff have certainly not been limited to alcohol and/or narcotics abuse. MCDH has employed physicians and department heads whose behavior toward patients, family members, and visitors has been nothing short of abhorrent; and continued to employ these persons far too long after the abusive behaviors were common knowledge.

As the editor of the AVA wrote last week: Test the bastards.

The MCDH Board candidates pretty much all agreed that they would oppose outsourcing any job(s), but this writer has ample personal experience with the inability of MCDH to bill patients correctly. AVA articles from January 8 and 22, 2014 contradict Kermen's claim that MCDH employees work better than outsourcing. Kermen's statement that MCDH employees prove more economical than outsourcing is refuted by the practices of other businesses on the Mendocino Coast, where outsourcing parts of the paperwork load frees up local employees to do their regular jobs better and more efficiently.

Bottom line: Mendocino Coast District Hospital needs a new approach. It cannot go on with the same old, same old. Perhaps the talented but less than collegial Drs. Rohr and Glusker can bring about needed change. Who knows? There are many younger, capable physicians on the Mendocino Coast who might be able to bring about a balance between budget cuts and proper patient service, but they are either hanging back waiting to see how things shake out post-bankruptcy or they haven't been given enough encouragement to leap into the fray. If we're really lucky, more everyday citizens might throw caution to the wind and wade into the muddied waters of the MCDH Board of Directors.