Southern Humboldt Community Healthcare District staff is rallying to continue a high standard of health care to the community in the wake of the resignations of clinic medical director Dr. Mark Phelps and his wife, clinic nurse manager Brook Phelps.
”The main thing we want people to know is that we are still here and that your care is our foremost concern,” clinic patient care coordinator Dana Habeck told nearly 40 people attending a town hall meeting called by SHCHD board member Darryl Cherney last Friday evening, August 13.
Hospital and clinic staff have been meeting since the Phelpses announced their resignation last week to develop a short-term strategy to be sure patient needs are covered, while the district administration has stepped up recruiting efforts for permanent, community-based medical providers.
Beginning in September Dr. Peter Nash, who has been working one day a week at the Garberville clinic and one day a week at Redwoods Rural Health Center, will provide the required physician oversight of the Garberville staff as well as seeing patients.
Dr. Nash has 30 years of experience in clinic-based medicine, has been a clinic medical director and director of quality in a large hospital.
The contract physicians now working in the emergency room will also be seeing patients in the clinic.
Since longtime physician’s assistant Larry Smith left the clinic three weeks ago, three qualified candidates have been found to fill his position, according to SHCHD administrator Harry Jasper.
All three are certified as “advanced practitioners,” either as physician assistants (PA) or family nurse practitioners (FNP), and all three have ties in the Southern Humboldt community.
In the meantime, the clinic has found an experienced PA who is willing to work five days a week for the next 30 to 90 days to help during the transition period.
Jasper also praised the continuing support of Linda Candiotti, who has 20 years experience as a qualified PA, and he thanked both Dr. Nash and his wife Judy, a family nurse practitioner. “They have stepped up in a unified way and so has the entire clinic staff,” Jasper said.
As for the long term strategy, Jasper said that management has been recruiting for a new doctor for months, since well before Dr. Phelps announced he was considering resigning.
They have been advertising with the National Rural Recruitment and Retention Network, also known as “3RNet,” a service for member nonprofit organizations that helps find health care professionals for rural and underserved areas.
District management has also been looking at the pool of independently contracted emergency room physicians as a recruiting tool. Serving in the ER enables both the doctors and management to find out if a permanent position in Southern Humboldt is a good “fit” for both the doctor and the district.
”Small rural hospitals like ours attract physicians who are familiar with both ER and family practice,” Jasper pointed out. Some ER doctors are family practitioners who are ER certified and others have learned ER practice by working in rural small-town settings that require a doctor to do both jobs.
In the past physicians and physician assistants at both the Garberville clinic and Redwoods Rural Health Center worked in the ER as well as in the clinics.
The district will now be recruiting for two doctors, a new medical director and a second physician to work and live in the SoHum community.
Because the medical director position offers a higher level of compensation and benefits as well as the challenge of directing a rural clinic, Jasper hopes the position will attract a mature, experienced physician.
”I’m the new kid on the block. I can’t imagine what it’s like to be in Mark Phelps’s shoes, having grown up in this community, and managed a staff of 75 people,” Jasper said.
He added that he hopes healing of conflicts will happen and expressed his support for the patients, staff, and the district governing board.
Nearly 40 people attended Friday evening’s meeting at the Veterans Hall in Garberville, including four of the seven candidates for the three open seats in on the SHCHD governing board, two former governing board members, and nearly a dozen hospital and clinic staff.
Cherney, who said he had called the meeting before the Phelpses resigned, hoped the gathering would come up with ideas “on where to go from here.”
He circulated a petition including four points: to ask the Phelpses to rescind their resignations, to restructure the administration “so that it is not top heavy,” to create “a worker friendly environment… conducive to retaining personnel,” and to “cut the salaries of top management making over $60,000/year so that we can give staff raises… and put funds in escrow in anticipation of hiring new doctors and a director of nursing.”
Participants sat in a circle and began the meeting with a go-around, introducing themselves and stating their purpose for attending. Most people said they were looking for more information and wanted to hear what others had to say.
While everyone expressed support for the Phelpses, many people, particularly staff members, emphasized the importance of looking ahead and maintaining health care for the community rather than trying to change the Phelpses’ decision.
Many longtime patients were present, some who had lived in the community all their lives and whose first family doctor was Dr. Jerold Phelps, Mark Phelps’ father. One person recalled Mark Phelps as a child “running all around the hospital.”
Although scathing criticisms of management were aired, several people pointed out the improvement in district finances since Jasper came on board. Facilities manager Kent Scown told the group that it had been generally accepted that new state seismic standards would shut down the hospital in a few years, until Jasper mobilized the earthquake retrofit effort and found the funding to support it.
Other people declared that the condition of the building doesn’t matter if Dr. Phelps isn’t in it.
One angry speaker stated, “If Dr. Mark sees one patient a month that’s good enough… I want a letter of apology to Mark! He should be paid to stay in this town by any means necessary… He deserves it!” She received a round of applause.
When Habeck read the clinic staff’s letter to the editor stating their desire to go forward, this speaker said, “That sounds to me like ‘roll over and scratch my belly.’”
Several people called for mediation, peaceful resolution, and an end to name-calling.
A number of employees complained that they felt they had no voice, were not allowed to organize, and feared retaliation if they spoke out.
”When there are so many resignations among employees who have been here such a long time, that means something’s wrong… Are these kinds of resignations sustainable?” asked one of the senior employees, noting a critical shortage of nursing staff that required “traveling nurses” to fill in the gaps.
A paramedic who has worked for over 25 years for the ambulance service, a separate organization completely independent of SHCHD, pointed out that there is also a high turnover of paramedics and EMTs. “We can only cover because everyone’s working overtime,” she said. “[High turnover] is everywhere.”
Some staff members also complained about new, relatively inexperienced employees receiving salaries nearly as high as those of older experienced employees.
Regarding the controversial coding issue, an ER team employee explained that before the health information manager came on board the ER had consistently been losing money because they had failed to keep up-to-date on coding standards.
”I wonder how much money was lost in the last seven years because of failure to change codes,” he said. “The paperwork is a pain in the a–, but it brings in more money to help keep the hospital going. I hope so, because otherwise it’s just a pain in the a–.”
Former board member Dave Kirby said he wanted more respect shown to board chair Nancy Wilson, reminding the group that Wilson came on the board some years ago during a financial crisis that nearly closed the hospital down. “Without her we couldn’t have kept the doors open,” Kirby declared.
But other speakers faulted the board for not keeping closer watch on the situation and the staff at the time. For a while the meeting threatened to devolve into a verbal brawl, with various people accusing each other of responsibility for past mistakes.
Cherney put some white paper up on the wall, asking for suggestions for improvement. Suggestions listed were: employee representative on governing board, employee grievance committee, employee union, a letter of thanks and apology to the Phelpses, an end to “mean-spiritedness,” and a “nice policy.”
After two and a half hours, as people began to drift away and talk among themselves, Cherney thanked the participants, saying, “This was a better meeting than I thought it would be.”
REDWOOD TIMES PHOTO BY VIRGINIA GRAZIANI
A circle of nearly 40 people, including hospital/clinic patients, employees, and governing board candidates talked about the future of the Southern Humboldt Community Healthcare District at a town hall meeting at the Vets Hall last Friday evening.