To serve the community, provide cradle-to-grave care

By Erin Graham | March 12, 2019

Baby held by doctor just after being born.

At a time when many rural hospitals struggle just to keep their doors open, some are doubling down on their commitment to servicing their communities – and even expanding services. Take 25-bed Gibson Area Hospital & Health Services in Central Illinois, which has bucked the trend of dropping OB specialty services. Instead, in 2014 they built and staffed a brand new labor and delivery facility.

Rob Schmitt, CEO, talked with athenaInsight about why Gibson is committed to prenatal care and delivery for the long haul.

Many rural hospitals are cutting back in obstetrics, but not you. Why have you taken the opposite approach?

It starts with an organizational commitment to OB from the board of directors. They have a strong sense that in order to be a true community hospital, you have to provide cradle-to-grave services. And being able to have that great, first family moment happen at our hospital attaches families here, and we don't want to lose that.

So, it's been that top-down commitment from the board, which says, "We will be doing OB and we will make sure we have the resources to do it." And it's been a hugely successful program.

Secondly, we have a strong medical staff that didn't want to lose these skills.

They really drive the organization. Our medical staff members are entrepreneurs, are very forward-thinking, are not adverse to risk. They're the ones who are saying [that] we should have this service, and recruit this specialty. Or, let's put an office in this community. Let's expand our footprint. Let's add this service to the community because they lack that service for whatever reason.

Who is on your delivery team?

Of course, one of the keys to delivering babies in rural areas is having enough providers to deliver. A lot of hospitals have one or maybe two docs, and that becomes very onerous on their personal lives and on their families.

Here, we have six family practice docs who all deliver and we're adding a seventh. We had as many as nine at one point. And a one-in-nine call rotation for an OB doc is wonderful. About every two months I have to take call? That's great! So that also helps attract, from a recruitment standpoint, other docs.

So many small hospitals are cutting OB because it's a loss center. What's your view of OB both financially and in terms of the community?

We're firm believers that if you lose OB, you really start to lose the core of the community hospital. And yes, there's plenty of hospitals that don't deliver babies that are still around and still provide care, but we've been committed to saying, "We're here for you as an organization from the first of your life until you're no longer here." And we've committed money and resources and doctors.

We don't measure success financially. We're not delivering babies because it makes us money. We deliver babies because it's a great service to provide our community. From a pure financial standpoint, we need to deliver 300 babies a year for the service to break even. Fifteen years ago when I came here, we delivered 150 babies a year. We delivered 251 babies last year, so we're getting closer to breaking even, but that's not the driving reason we provide the service.

You've won a Women's Choice Award for your OB services. How important is it for a community hospital to connect with the women in its community, whether it's at birth or otherwise?

It's absolutely necessary. The wife/mother/female makes the healthcare decisions, whether it's [for] the family itself, her parents, or his parents. And if you make sure that you connect with the females, make sure they feel safe and that they believe you're a quality organization, then they're going to drive the rest of their family to you.

That's been kind of one of those core beliefs of the hospital. The board has always said, "Happy doctors make a happy hospital." Well, the same thing applies: Happy moms make happy families.

What are the risks in not focusing on recruiting in community OB?

For some hospitals, it's just the fact that their medical staff has aged out and they haven't been able to replace them. And the community's like, "Well, if you're not going to have any new docs coming, then I need to go see somebody in another town." If those families start driving somewhere else at the beginning of their family lives, it's hard to get them back.

Erin Graham is a frequent contributor to athenaInsight.

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