OB Ad Hoc Committee Continues To Struggle

Meeting lacks facilitation skills, healthy confrontations occur

Marianne McGee  & Terrence Vaughn 02_17_2017

The third meeting of the MCDH OB Ad Hoc Committee was frustrating and chaotic as Chair Dr. Kevin Miller lacked facilitation skills and attempted to force this meeting as a conclusion of its charge.  On the other hand, with all members present except for Dr. Abramson, it appears that through the chaos and confusion, people shared honest and open thoughts, feelings and sincerely discussed some issues.

The purpose of the meeting was to review, discuss and refine the first draft of the Committee’s report to be submitted to the MCDH Planning Committee.  Watching the meeting, it is apparent there is still not clear consensus on the goals and mission of the OB Ad Hoc Committee, which has a tremendous impact on the outcome and structure of the final report.

As Committee members went through the draft report, there were discussions and clarifications on what the actual facts were, their relevance to the task at hand and what revisions to the report as written needed to be made.  Mendocino TV initially published the draft report here and then decided to remove it as there are substantial factual details that need to be corrected, so we did not want to contribute to the chaos and confusion by publishing misinformation.

One source of the meeting conflict, which resulted in healthy communications, was whether this was just a list of obstacles and challenges or was the group going to include potential solutions or ideas that may improve the financial issues pertinent to OB, as well as other departments. Volunteers Carol White and Tanya Smart clearly spent a great deal of time researching the issues and gathered data from many sources, which too often were met with “that’s too big” from Chair Miller or feedback amounting to “we already do that” or why something would not work. While it appears many members want to further explore and include more “out of the box” ideas and solutions, Dr. Miller’s rush to get this completed, appears to preclude this.

It was refreshing to hear Lucresha Renteria, Mendocino Coast Clinics (MCC) Executive Director, and Wade Sturgeon, MCDH Chief Financial Officer, express how difficult this process has been as they have felt attacked at times and defensive as if they are causing the problems. Their participation and information have contributed substantially to understanding the issues, needs and operations of both organizations. It has also fostered what appears to be an increase in support and collaboration between the two entities.  MCC is now covering half of OB 24/7 call coverage for the hospital and has just hired a new Pediatrician so will be covering 25 days of hospital call coverage for pediatrics as well, which is a fundamental requirement for OB.  While Dr. Abramson and Dr. Miller have indicated MCC should pay for it all, it is actually very unusual for a health clinic to provide any hospital call coverage. Additionally through these meetings, MCDH expressed interest in helping MCC potentially recruit another OB provider to lower the costs of OB on call coverage and eliminating a source of competition between them.  So, a positive outcome of this process is a new spirit of cooperation and mutual understanding.

As the frustration regarding the structure, process and content of the report increased, Dr. Bella and Dr. Wright offered suggestions that were angrily shut down or attacked by Dr. Miller. The agenda that Dr. Miller was dictating was that this report was now done except for the changes today, there should be no more meetings and community input was not welcome.

Given my years of experience as the MCC Resource Development Director, I was distraught to see the report conclude, without contradiction, “The role of the (Mendocino Coast Hospital) Foundation is to raise money to provide funding for capital equipment needs at Coast Hospital”.  Since Dr. Miller refused to call on me, I finally blurted out the mission statement, which is to “support MCDH’s ability to deliver quality healthcare services”. While it is accurate that funding capital needs has been the priority, given the tremendous level of community support for OB in the recent MCDH phone survey, I think a targeted fundraising campaign would raise funds from people who are not currently donating.  While Dr. Miller dismissively told me it was already discussed, the only dialogue was that if the Foundation contributed for a different cause, “it would just  rob Peter to pay Paul”. So, my suggestion that perhaps new donors might be recruited and cultivated was disregarded.

It was very disturbing to see the lack of leadership skills exercised by Dr. Miller, once again, in this meeting.  At times he literally turned his back on the person speaking; he was busy on his cell phone and behaved condescendingly.  He dominated the meeting by not facilitating group communications, not listening, dictating his position and aggressively challenging people.  Don’t take my word for it, watch the video yourself!  Sadder yet is the fact he will be the person responsible for leadership on the MCDH Board Planning Committee, where this report will be tackled next.

It will be interesting to see the report, since at times you cannot understand what is said with people all talking at once without a skilled meeting facilitator and no clear consensus on details or summarization.  It is difficult to know if John Allison, who is writing and editing the report, will include proposed suggestions or just follow Dr. Miller’s edicts.

In the end, asking for a vote, enough members, including Mr. Allison, decided there is a need to meet face to face to finalize the report on March 1 at 4:00 PM, fully a month earlier than the initial deadline given by President Lund.

While this meeting was chaotic and frustrating, it was successful in that people had honest and genuine discussions; they were not just shoving papers, reports and data at each other.

There are national and local issues that need to be delved into as the MCDH financial problem solving process moves forward, regardless of this report.  It is a fact that the nation’s healthcare crisis is in flux and there is no clue as to what will happen, next given the political volatility.  Rural hospitals and clinics are particularly vulnerable and our community is one of the few survivors of this public model as well as our unique geographical isolation.

There are also critical local issues and here are a few examples:

  • If, as indicated at this last meeting, Ukiah will only accept pregnant women at 20 weeks or less, if we can retain OB services, what is the impact if delivery must occur in Santa Rosa or Eureka?
  • How will both the organization and patients deal with transportation issues?
  • How will the potential need for land and air ambulances be impacted if OB is closed?
  • If Fort Bragg is betting its future on the development of the mill property, how will it attract people without a viable hospital and critical healthcare services?
  • We have an unusually high percentage of aging population, how will we deal with their care needs?
  • What is the role or inclusion of Mendocino County and City of Fort Bragg officials in our healthcare discussions?
  • What is the role of the Adventist healthcare system in these deliberations, as they also have a clinic here?

As we know, there are no simple or predictable conclusions to our local healthcare dilemmas. The only apparent response is that, as a community and individually, we must be attentive, well-informed and involved.