The value of a local hospital

These are troublesome and very complicated times for health care providers and facilities who must live with the reality of soaring costs and dwindling revenue streams, while planning for an uncertain future as national health care reform policies are implemented.

It is against this backdrop that the Petaluma Health Care District has begun to formally evaluate whether St. Joseph Health System, the organization contracted to operate Petaluma Valley Hospital, should continue to do so once its 20-year management contract expires in four years.

Historically, the relationship between the health care district and St. Joseph's has frequently been marred by conflict. Years of ill will, distrust and a profound failure by local physicians and St. Joseph's to properly communicate and collaborate with one another only made matters worse for a health-care system already on the ropes.

In the months preceding the 2008 health care district board election, several candidates alleged that the hospital was being poorly managed. Physicians charged that St. Joseph was not adequately recruiting physicians, so they set off to try and do the job themselves, unsuccessfully. Physicians also failed in their attempt to establish their own outpatient surgery center, a move that local health-care officials felt could threaten the very survival of Petaluma Valley Hospital

But since early 2009, after St. Joseph hired a new CEO for its Sonoma County operations, Kevin Klockenga, the relationship between the district, local physicians, and St. Joseph has improved markedly. Klockenga, who rapidly gained the respect of the local medical community for his openness, collegiality and collaborative approach to solving the many difficult challenges facing the local hospital, is widely credited with having helped turn things around.

The problem of physician recruitment and retention has begun to improve, in part due to the work of the St. Joseph Foundation and the Annadel Medical Group, a physician group supported by St. Joseph's.

Another significant achievement has been the establishment of an agreement whereby physicians are being paid by St. Joseph to manage the hospital's operating room, a move that has quieted doctors' talk of establishing their own outpatient surgical facility.

Working together, local physicians, the district and St. Joseph officials have restored a sense of trust in Petaluma's health care environment. Partly as a result of this newfound collaboration, Petaluma's hospital was ranked one of the very best in the country according to a 2011 survey by the nation's leading accreditor of U.S. hospitals.

Still, not everything at the hospital is perfect. The operation continues to lose money, and labor struggles over nurses' compensation, specifically on-call pay, have yet to be resolved. But, on the whole, Petaluma's hospital is in good shape.

As its contract with St. Joseph approaches its expiration, the hospital district has begun to evaluate its options which include renewing its contract with St. Joseph, seeking a new management partner to operate the hospital or managing the hospital itself.

The elected five-member board of the publically owned health care district will have to make that decision, but it's important that members of the public stay informed and weigh in on what they believe is the best course for the future of their hospital.

To maximize public participation, it is important that the health care district board not repeat its recent meeting where it inappropriately, if inadvertently, discussed its strategic plan behind closed doors. Such discussions and decision-making to ensure that high quality, affordable and convenient health-care services are preserved in the south county should be made with input from interested and informed Petaluma residents.