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CPH deserves support of community

Posted: January 25, 2012 - 8:58am

The proposal to build the Kahtnu surgical center seems to be the doctors' angry response to former hospital CEO Ryan Smith's attempts to muscle them into joining the hospital staff.  As one health-care provider put it, Ryan was trying to bring Central Peninsula Hospital into the 21st century as fast as he could and this involved trying to reduce costs by exerting pressure on these doctors to become hospital employees.

Ryan's economic argument made sense but the execution of the plan was high-handed and insensitive to the needs of the doctors, according to several sources I spoke with.

So against this backdrop, the idea of the Kahtnu surgical center evolved. America is the land of free enterprise -- at least that's what we keep trying to tell ourselves despite abundant evidence to the contrary -- but the only people who are going to benefit from the surgical center are these eight doctors.  Yes, their costs to deliver services to the public might very well be half of what it costs the hospital to do this but is there any guarantee that Kahtnu's owner/physicians will pass this savings along to the public? In my experience, competitors with low expenses rarely charge much less than their competition so there is little economic advantage for Peninsula residents to support Kahtnu.

On the other hand, there could be distinct disadvantages to the day surgery center. Don't forget that we are the ones who own this hospital.  We are also the ones who will be left holding the bag if Kahtnu cherry-picks the profitable day-surgery patients away from the hospital.  Many of the hospital's expenses are fixed -- they'll remain the same whether five people are cycled through CPH's day surgery center or 25 people.  So if the hospital loses these profitable patients to Kahtnu, who will the hospital turn to in order to keep the lights on?  That's right.  Us.
Personally, I am very proud of our hospital.  When you consider our relatively small population, we are blessed to have a wide array of physicians who serve us along with gifted, dedicated nursing and support staff.

I sincerely hope that the hospital and these eight physicians will bury the hatchet and negotiate with each other in good faith in order to hammer out a plan that meets their mutual needs as well as the public's needs.

Supporting Kahtnu surgical center would be the equivalent of knee-capping Central Peninsula Hospital. Please contact Karen Lawfer at karen.lawfer@alaska.gov and let her know how you feel about this.

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Carver
1135
Points
Carver 01/26/12 - 07:22 am
0
0
Maybe not . . .

Well said, Eric, I think you've nailed the problem and its causes. That said, I doubt the proposed surgery center would "knee-cap" CPH. That's probably an overstatement.

First, CPH has enough extra money to be giving it away to area entities such as the Watershed Forum, the Food Bank, and Kenai River Sportfishing Association. What's up with that? Who gave CPGH Inc. permission to become a vehicle of patronage? Maybe, should such actually occur, a few less bucks floating around CPH coffers might be a good thing?

Second, the proposed surgery center might actually increase business for CPH by inducing more area residents to stay home instead of running off to Anchorage for day surgeries. Consider: if one wants to open a new, say, clothing store, the best place to do it is in a mall with other such stores, and the increased supply induces increased demand to the benefit of all.

No easy answers, but I am inclined to bet on the free-market and competition over the long haul. Our system isn't perfect, far from it. Changes are coming, indeed are upon us, but monopoly is not where we need to go.

Like you, I too wish Inc. and docs would bury the hatchet. And like you, I believe Inc.'s and Smith's high-handedness were and are a big part of the problem. Self-appointed boards such as Inc., accountable to no one but themselves, have a tendency to become enamored and identified with the people they hire as seems to be the case with the Smith administration of CPH. He and Inc. were miles out of touch with the public with Inc.'s proposal to sell the hospital.

While the folks who make up CPGH Inc. are trying, I'm sure, to do the best they know how under current conditions, residents would likely be better served if Inc. were an elected board as is the board of Homer Electric. Same folks could serve, they'd simply answer directly to the public for their decisions.

Allow me to recommend a book: "The Social Transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry" by Paul Starr. The book won the Pulitzer Prize for General Non-Fiction in 1984. The title of the book'a last chapter is "The Coming of the Corporation."

And here we are . . . .

corinnep
294
Points
corinnep 01/26/12 - 04:16 pm
0
0
I Don't Want Politicians Running the Hospital

I don't want politicians running our local hospital. That's what would happen if there was an elected board.

Anderson Fannon
0
Points
Anderson Fannon 01/27/12 - 08:38 am
0
0
Giving to the Community...

Businesses usually donate money to community organizations to show appreciation, or as a form of advertisement. While you may disagree with the specific organizations the board has donated to, its difficult to fault them for the act of donating.
Ryan Smith left the Peninsula a pariah due to his attempts at selling our Borough owned hospital, but his accomplishments are many, and his boss is the board. Ryan was not the only motivated individual in selling CPH. He was instrumental in making CPH something it has never been.
The problems I see are that the board is not appointed by the owners of CPH, and the community rarely shows very little "Pride of Ownership"... something Ryan Smith tried to instill in CPH employees.
As always, I will try to do the best to represent CPH, and take the best care I can of my fellow Peninsula residents. I work with some amazing people in a demanding field. No one is perfect, but we are trying.

cbeard
132
Points
cbeard 01/27/12 - 10:10 am
0
0
Dumbfounded

I'm utterly dumbstruck by this article's purpose.

So, there are 8 doctors who do not get along well with or disagree with the practices at Central Peninsula. Fine.

What is preventing them from establishing their own medical facility going to do? Make CPGH feel like they won an argument?

All it will mean is 8 less doctors for the Peninsula, because they'll just find work elsewhere. In case you didn't know, doctors are fairly hard to come by.

These doctors have NO RESPONSIBILITY TO "NEGOTIATE" WITH ANY PRIVATE BUSINESS THEY DON'T WANT TO. CENTRAL PENINSULA HOSPITAL IS NOT THE GOVERNMENT NOR THE HEALTH AUTHORITY OF THE PENINSULA LIKE IT'S TRYING TO MAKE ITSELF OUT TO BE.

RaySouthwell
1054
Points
RaySouthwell 01/27/12 - 08:00 pm
0
0
My friend Eric

I enjoyed your letter until the end. We must stay focused on the root cause of the surgeons desire to build Kahtnu. In the end you oppose them.

I am reminded of my friends who oppose Occupy Wall Street. They understand the problems but get lost in the rhetoric of pros and cons of the OWS folks. I try to get my friends looking at the root cause of the problem. They get lost in the peripheral issues and become opposed to OWS.

Please do not get lost in the peripheral issues with Kahtnu and stay focused on the root cause of the surgeons desire to protect their livelihood.

RaySouthwell
1054
Points
RaySouthwell 01/27/12 - 09:45 pm
0
0
Anderson

You stated-
“As always, I will try to do the best to represent CPH, and take the best care I can of my fellow Peninsula residents. I work with some amazing people in a demanding field. No one is perfect, but we are trying.”

I believe the surgeons would say the same.

However, your work environment is protected by labor laws. The surgeons as well as your ER docs have no such protection-ask them.

Remember a few years ago when the ER docs were told to take a pay cut or their contract would not be renewed. I believe management threatened to bring in rent-a-docs to supply the needs of the ER.

Management did it in the Imaging Department in 2008.

It could never happen to you because of labor laws.

bewildered
9
Points
bewildered 01/30/12 - 03:46 pm
0
0
This whole thing has to do

This whole thing has to do with one issue as Ray says "the root cause". Bottom line is: Certificate of need. Is there a need for these 8 docs to open a surgery center?
That is the question the state of Alaska is burdened with. That decision if there is a NEED. Our populaion is just over 20K other areas in Alaska that have a surgery center and a hosptial have over 100K. The numbers are simple. NOT a need. There is not enough room for both to operate and be propserous.

Physicans can bully just like everyone else and yes they have a bit more stroke, afterall we are THEIR patients right? and we trust them with our health and well being. For the record Dr. Zirul has tried this MANY times before, It has NOTHING to do with management at the hospital. This is a business decision for them.

I personall will continue to support the hospital so that all of my fellow community memebers will have services they need even I or my family never need such services. I will support them so that we all will have them to be better citizens to have a better community as a whole. Not just of myself but for the betterment of my community.

RaySouthwell
1054
Points
RaySouthwell 01/30/12 - 10:20 pm
0
0
bewildered

Bewildered,

The root cause is the answer to my question-

Why are 8 surgeons feeling a need to take a $9 million dollar risk to build an Ambulatory surgery center.

As far as I am concerned there are only two choices. These surgeons are greedy or they want to economically survive in the community they serve and love.

I do not believe they are greedy. So why do they feel a need to economically survive.

It goes to the question I raised almost three years ago, the management style.

Anderson Fannon
0
Points
Anderson Fannon 01/31/12 - 01:48 am
0
0
Is wanting to make more profit greed?

I do miss you Ray.
I disagree with your two options, and your choice of words. Is it greedy that Safeway starts selling a popular item, just to make more profit? No.
Is it greedy that our Doctors want to make more profit? I don't think so. It's what we humans do (most of us). We work hard, either physically, or by having great ideas, that hopefully profit. This is not greed, but a mentality of successful people.
Regarding your choice of words, a surgical center would involve minimal "risk". I personally believe it would profit the Doctors without question. If this weren't the case, CPH would not be fighting it so aggressively. The Board believes whole heartedly income would plummet.
If these Doctors felt bullied, as you believe, they would quit working inside CPH as soon as the Surgical Center were built. But this is not the proposal. All of them plan to see and treat patients in both the Surgical Center AND here at CPH, if the Center is built, maximizing profit.
I understand that your relationship with Ryan Smith was not friendly. He was respected out of fear by a lot of employees... which I think we both agree is not true, honest respect. But Administration has changed, and although the Board remains essentially the same, I have hope that this Administration will EARN respect of those employed by CPH.

RaySouthwell
1054
Points
RaySouthwell 01/31/12 - 03:08 am
0
0
Anderson

Perhaps I will be back to work soon.

Our fallen nature of self interest drives us all. It is what makes capitalism the most successful economic system on the planet, for the advancement of humanity.

Health care dollars are shrinking. The surgeons are taking a $9 million chance to make “more profit” in a healthcare system that is shrinking. I don’t think they believe they will make more money, they are trying to survive. They realized if they want to stay in the community they needed to develop a system that protects their practices.

In the end we will all lose because CPH, the doctors and nurses will all be fighting for the heath care dollars. In California there are laws for minimal staffing requirements. In Alaska a law has been established against mandatory overtime. Healthcare professionals must work together for our survival. That is, Doctors, nurses and managers must work together for the community. Management and the doctors are in a battle for control. Nurses have also been in the battle for control of our practice. We all lose, if we do not come together.

Kathnu will give the surgeons complete control and put the INC. board in a position to negotiate with them.

I now understand that Ryan Smith was the scape-goat of the boards direction. It is clear to me. Ryan has been blamed for all the management problems at CPH. What I did not understand, is why he pursued forcing the surgeons into compliance of the corporate agenda when he was leaving. It was the last direction of the INC. board, before he left.

When I told my National Labor Relations Labor Board attorney about the surgeons situation, he said they are on their own. You need to understand the surgeons are fighting back against the management style. I have done the same, using the labor laws that do not protect the surgeons.

Have you talked to the ED doc’s about how they are unprotected against the management style as you are?

This is about surviving and staying in the community. I have used the best way to protect my livelihood and the surgeons are using their only option.

Norseman
3616
Points
Norseman 01/31/12 - 07:05 am
0
0
This is NOT about protecting livelihood

Ray, your stance is that the only reason the surgeons are pursuing this if for the survival. That will not hold water.

I begrudge no one for being successfull in life, I do not resent rich people, I believe to try to earn a profit is what drives our country.
But for you to state time after time that the only reason these Doctors are doing this is for survival is bs.

I know most of these Doctors. Great doctors and fine people. They also are rich by local standards. They own mighty fine homes, cars, and toys. They take more trips to exotic locations each year than most of us will take in a lifetime.
They have access to things that are not within the reach of an ordinary man or woman.
These are not people who are about to lose there way of survival. These are smart, intelligent, people who can see a long term profit for themselves.
There standard of living will not go down if this doesn't go through. They will not lose there jobs. They will just find another avenue to invest the profits they are currently making.

RaySouthwell
1054
Points
RaySouthwell 01/31/12 - 09:17 am
0
0
Norseman

We disagree.

However, I do agree that most people are driven by money. We love it and want more of it. The global economic situation is the end result of the peoples love of money.We have forgotten what true wealth is.

I heard the rumors before. Employees at CPH were told it was my love for money that I spoke out against management. Nurses had no contract and I was using the abusive management style as a tool to get more money for the nurses.

I don’t think anyone believes that now.

Now the new rumor, surgeons want more money.I don’t agree. I have seen how it works.

I am neither for or against Kathnu. It is the division in the community I am against. In the end the people will lose. Doctors, nurses and corporate management are fighting over healthcare dollars throughout the nation.

It has hit here and the owners/people will lose in the end.

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