Hospital board ponders future of obstetric services

An agenda item calling for a discussion of women’s health issues turned into a pro-obstetrics rally, as a parade of medical professionals implored the Sonoma Valley Health Care District Board of Directors to fully support maternity services at the hospital.
Board member Arnold Riebli said that because of dwindling revenue it may be time to take a hard look at paring back or eliminating the hospital’s OB capabilities. “Do we have to eliminate parts of the hospital to keep priority services?” he asked. “It may not be that OB is the only line we look at paring back.”
Paul Amara, M.D. was one of many to counter Riebli’s admittedly unpopular opinion. “If you eliminate OB services, you severely impact the number of women who use the hospital during their lifetime,” he said. “It would be the beginning of the end of the hospital.”
Board chairman Bill Boerum disagreed that maternity is the central hub of women’s health care. He cited the statistic that 72 percent of female patient visits to the hospital are by women aged 45 and over, and suggested that perhaps that age group should be the focus. “Let’s not push for new OB at the sacrifice of services for older women,” he said.
OB/GYN and lifelong women’s health are complementary, said Mike Smith, a former board member. “There is no conflict. A full spectrum of service is a necessary condition for survival.”
Expecting immediate profits from that 45+ sector is unrealistic, according to Amara. “You can’t pick up health care patients at 45 and 50. It’s all based on relationships formed earlier.”
Pediatrician Charles de Torres, M.D. agreed that a positive birthing experience has an exponential effect.  “When I get the baby (to care for), I don’t just get the baby,” he said. “I get the aunt, the grandma and the 30 relatives in the hallway. All of these people will be back.”
It was also suggested that a strong OB/GYN department can be a useful tool in recruiting physicians to Sonoma, which has been a challenge given the hospital’s recent history. Several of the speakers voiced confidence in CEO Carl Gerlach’s plan to improve OB/GYN services, which include hiring a woman gynecologist and sprucing up the delivery rooms to create a better first impression.
“This is a touchstone moment,” said Jerome Smith, M.D., who said the board could bolster the organization’s image “with a commitment to keep the hospital intact.”
Only by providing a full range of services, suggested community member Norman Gilroy, will Sonoma Valley Hospital become the hospital of choice for the area. “You as a board must stop talking about pieces and start dealing with the whole,” he said. “The idea of curtailing services is extremely unsettling for the community.”
“I’m angry and offended this has even come up,” echoed Dr. Robert Cohen. “I ask the Board for a vote of confidence.” But no action was taken, as Boerum reminded the members that this item was on the agenda for discussion only. Gerlach noted that the spirited dialogue was a “dry run” of the newly announced Public Forum, which is a monthly meeting intended as a venue for discussion and debate among doctors, administrators and the public.
In other business, the board voted to dissolve the hospital’s Strategic Planning Committee, which had outlived its usefulness.