Letters to the Editor, July 27 - 30
Hospital cuts make sense
EDITOR: Living in Sonoma we are blessed with the Sonoma Valley Hospital, a very small community focused hospital with an excellent safety and quality record — a place we can be proud of and feel confident taking our loved ones, and ourselves, in an emergency or for routine services. Across the country, and California, hospitals of this size are closed, closing, or considering closing because the finances simply no longer work. In Sonoma the community has been generous with financial support subsidizing the hospital’s operating costs through the parcel tax and the Sonoma Valley Hospital Foundation to ensure that we continue to have high quality emergency medical services.
Many people are not aware that the Emergency Room revenues do not pay the cost of ER services, not only in SVH, but in all hospitals. The ER is supported on the back of other hospital services that generate income — so it is critical to have all hospital services generating a positive cash flow. Regretfully SVH has a few services that are losing money and from all projections will continue to lose even more money going forward.
We have an excellent Skilled Nursing Facility (SKF) that has won numerous awards. The Home Health Care is excellent as well, so good in fact that Kaiser contracted with SVH to provide those services to Kaiser patients in Sonoma Valley. And the Obstetrics (OB) unit is universally praised by those few who use the services. Despite the high quality of these programs and their excellent staff, SVH can no longer afford to subsidize them financially.
For the SNF and Home Health Care there are other excellent options available right here in Sonoma Valley to take the patient load. Regretfully the same cannot be said for OB. I voted to keep OB open in 2014 when I was on the Sonoma Valley Health Care District Board of Directors (the oversight body for SVH). I believed then, and still today, that it says something sad about a community when babies are no longer born there. And having heard the large number of particular supporters from the community in 2014 I know closing OB is a very emotionally charged subject. But SVH births have fallen from about 12 per month in 2014 to about 8 in 2018. In 2014 all the birth projections predicted continuing decreases and that continues to be true in 2018. SVH has one of the lowest birth rates among hospital OB units across the country. Hospitals are closing their OB units when they are delivering 40 per month because they are not financially viable, and for safety concerns.
And… more important than money, is the safety of mothers and babies. With births so infrequent we are testing the fates. Safety in health care, like many things, requires well trained and highly skilled doctors and staff, which SVH is blessed to have. It is also well recognized in health care that frequent repetition builds and sharpens skills, knowledge and safety, particular for handling unexpected and life threatening events. As one doctor told me recently, anyone can deliver a baby, regular people have been doing it for thousands of years; it is in those unusual critical and life threatening situations when you need a highly skilled and experienced team that deals with deliveries all day, every day, and therefore has more frequent experience with life or death situations.