Wednesday, September 15, 2010

Guest Commentary: Dissecting Henry Mayo Newhall Memorial Hospital

The West Ranch Beacon’s mantra “Sometimes controversial, always thought provoking” can describe Henry Mayo Newhall Memorial Hospital. Most emergency and critical medical care in the Santa Clarita Valley is rendered there, yet most have no understanding of how our hospital functions.
I have been on the Medical Staff at Henry Mayo 23 years, and have a private practice specializing in geriatric medicine. As an educator, I cohost “The Senior Hour” on KHTS, wrote a column in The Signal “Profiles in Medicine”, and have had a television show entitled “House Call for Seniors” on Channel 20. For those who read this blog and are involved in City Council politics, you know that I fought to keep our Transitional Care Unit (TCU) open for our elderly, and questioned the recent hospital expansion through their Master Plan. As a primary care physician for seniors in this community, I consider myself to be on the frontline in healthcare, and therefore hope I can briefly present to you…without the medical jargon…how Henry Mayo functions.
The hospital is established as a nonprofit 501(c)3 which means it doesn’t have to pay taxes, but because of this status, is obligated to follow certain legal guidelines. Federal and state legislation maintains constant vigil over patient care to protect the public. Periodic unannounced inspections by The Joint Commission, California Health Department, and other agencies must be passed for the hospital to remain “accredited.”
Having practiced at Henry Mayo for over two decades, there have been tremendous strides in technology adapted by our hospital. It is much easier for physicians to now give state-of-the-art medical care to those critically ill patients. There is no doubt also that my colleagues and I have the best trained nurses, pharmacist, laboratory, x-ray, and other personnel (many of whom also live in this community) working with us at Henry Mayo Hospital.
The Medical Staff are physicians, most in private practice, some in groups, and others solo, like myself. We are bound and guided by “Rules & Regulations” and “Bylaws” that must be adhered to. There are some groups that have contracts with the hospital to give specialized care to patients such as emergency, trauma, anesthesia, radiology, dialysis, and pathology. Most of the physicians though are not contracted, nor are they paid or employed by the hospital. Payments for hospitalized patients are made to us from Medicare, MediCal, and third party payers (Anthem Blue Cross, Aetna, Blue Shield, etc.). The Medical Staff duly elects members to a Medical Executive Committee (MEC) that represents physicians as a part of the governing body.
There are three interactive governing bodies at Henry Mayo…somewhat similar to the Executive, Legislative, and Judicial branches of our government where there are checks and balances: The above mentioned MEC; the Administration; and final decision maker Board of Directors.
The Administration hierarchy is headed by Chief Executive Officer, Roger Seaver. Immediately under him are the Chief Financial Officer, Bob Hudson, Chief Operational Officer, John Schlief, and Chief Nursing Officer, Larry Kidd, RN. There are a myriad of department heads all of whom must follow highly regulated policies and procedures again laid down by federal and state agencies.
Finally, the Board of Directors are volunteer members who live or work in this community. They are the ones that must juggle all the financial and medical information to come up with the best decisions for the hospital and the residents of the Santa Clarita Valley.
Some physicians serve on the Board of Directors, some Board of Directors serve on Administration Committees, while some Administrators come to the MEC meetings. All the governing bodies therefore have links to enhance communication.
Painting this picture of functionality makes it seem all the necessary ingredients are in place for our well-oiled hospital to run smoothly. But do the Executive, Legislative, and Judicial branches of our government run smoothly?
Mistakes have been made, but we are legally mandated to rectify these mistakes and learn from them.
Differences arise from personality, financial, and political conflicts with a recent surge in dysfunction between the MEC and Administration. Divisive issues and divisive rhetoric are emblematic of this ongoing drama. The Joint Commission sanctioned Henry Mayo for this lack of communication, and the hospital has been given a deadline to rectify this problem or it will jeopardize our accreditation.
Fortunately, this problem does not have any direct effect on patient care…yet. As I shrug my shoulders and raise my hands into the air, I think Henry Mayo’s mantra should really be: “Sometimes thought provoking, always controversial.
Gene Dorio, M.D., -Commentary
Gene Dorio, M.D., is a local physician. His commentary represents his own opinions and not necessarily the views of any organization he may be affiliated with or those of the West Ranch Beacon.