“We, the undersigned…” – Medical staff at South County Hospital say urgent attention needed

On Wednesday afternoon we received a letter physicians and medical staff at South County Health and South County Hospital. The letter, printed in full below, follows a June action where hematology oncology providers resigned citing “chronic underfunding of the health care delivery system”.

The physicians said they have taken this extraordinary step due to the “potential decline in care stems from management decisions that challenge the survival of the hospital founded 105 years ago. This is a pivotal moment to let our voices be heard to help find necessary remedies, including the replacement of top management.” 

After this letter there is a response from the hospital.

This is what we received:

We, the undersigned, express our deep concern and urge that the pressing issues facing South County Health and South County Hospital (SCH) be addressed immediately to prevent systemic impacts on both the overall health system and patient care. We have taken the unusual step of coming together to highlight that these are not isolated complaints, but broader systemic and administrative concerns that require urgent attention.

As medical practitioners within the hospital or health system, former Board of Trustees members who have dedicated time and energy to advancing the quality of care, donors who have long supported these efforts, and concerned community members, we understand that this system must evolve with professionalism, collaboration, compassion and balance amidst the ongoing changes in healthcare landscape.

Our concerns include, but are not limited to, the following examples: 

• A lack of support and an adversarial relationship between executive leadership and providers, most recently exemplified by the resignations of the entire Cancer Center staff due to irreconcilable differences over issues directly affecting patient care. Although these concerns were frequently brought to the attention of management, they fell on deaf ears. Many patients are understandably worried over who would treat them during potentially life-ending illnesses and do not want to rely on unknown temporary providers to develop trust and confidence required for keeping positive attitudes during these serious health challenges.
• Recently the new Director of Radiation Oncology services, after dramatically increasing patient volume, resigned with similar concerns. Staffing these positions was a challenge before, now it may be less likely qualified candidates can be recruited under the current management.
• Cardiology practitioners are facing staffing shortages, with management’s inadequate response to the growing demands of a retired and ageing population. This has led to increased patient wait times, backlogs for diagnostic testing, and the relocation of staff offices to the basement—until physicians partnered with Care New England, which was necessary to provide increases in critical services. Currently, plans are underway to add additional physicians and a mid-level provider.
• An excellent group of primary care physicians employed by South County Medical Group all left the organization’s Woodruff Avenue location due to irreconcilable differences with management which they felt directly impacted adversely on patient care. A Westerly primary care physician has resigned over similar concerns.
• Unresolved issues within the Ob-Gyn practice that remain unaddressed by the hospital, contributing to ongoing concerns.
• The imposition of organizational “benchmarks” for patient care visits that disregard the professional judgment of practitioners, who are best positioned to determine their patient’s needs. For instance, nephrology staff may require at least one hour for thorough initial consultations and over 30 minutes for follow-ups, yet the hospital insists on shorter visit times, compromising comprehensive patient care in this complex population.
• A critical shortage of pulmonary services, with only one doctor currently managing an overwhelming backlog of patients, a situation that requires immediate resolution. General surgical services have also been impacted by the loss of a highly qualified surgeon.
• Other services such as the sleep lab, home blood drawing services, lactation counseling services, cardiac rehabilitation and the anticoagulation clinic have been eliminated or significantly reduced.  
• The management style of CEO Aaron Robinson, which has fostered divisions rather than collaboration, has often been characterized by abrupt, callous, and confrontational attitudes, as well as disinterest in the well-being of practitioners, former trustees, and donors. To protect privacy, specific incidents will remain confidential.
• A failure on the part of the Board of Trustees to address these and other significant issues, notably leading to a contentious exchange in July between physician trustees and Mr. Robinson. This situation has only exacerbated the challenges facing healthcare providers and delivery of care in the South County area.
• Many of these issues are being raised by the community and have made their way to social media.

In conclusion, we are gravely concerned that these unresolved issues have already had significant impact on patient care, the ability to attract and retain physicians/providers/hospital staff and will have a deleterious effect on the future of this hospital and health system, diminishing its ability to form necessary partnerships with larger, more sustainable entities.

Many other physicians, providers, former board of trustee’s members, donors and members of the public wanted to join us but feared retaliation either associated with their jobs, relationships or patient care.

As recognized by Trustees Chairperson Joe Matthews, such partnerships are essential for the system’s survival, to ensure that local care remains accessible to our community, and to uphold the century-old mission of this hospital. We must avoid forcing residents to seek care in Providence or other systems outside South County, which presents unnecessary travel burdens, personal difficulties, and disparities in care. Unfortunately, this is already occurring.

We urgently call on the Board of Trustees to take immediate and decisive action to realign management to safeguard the sustainability of our health system and foster a supportive, positive environment for both staff and patients.

RINewsToday reached out to South County Health for comment:

This is a response from Joseph Matthews, South County Health’s Chairman of the Board, and Aaron Robinson, CEO and President to the letter of complaint.

“South County Health, like most hospital-based health systems in the state, continues to navigate a challenging healthcare environment in Rhode Island, including costs that continue to skyrocket and underfunding resulting from disparately low reimbursement rates. This has systematically created an unsustainable healthcare delivery environment, and is the direct root cause of the challenges that all Rhode Island healthcare systems experience, not just South County Health, in recruiting and retaining providers, as well as their inability to fully invest in infrastructure. These challenges are not unique to us; they are being experienced by all healthcare systems across Rhode Island and is well represented in the most recent Boston Globe article explaining Lifespan’s strategic move to invest in hospitals across our border to tap into Massachusetts’s reimbursement rates.

Difficult decisions are necessary to ensure that we can continue to serve our community for generations to come, and this requires us to make some modifications to the services that we are able to provide from time to time. Unfortunately, in making the hard decisions necessary to carry on South County Health’s mission, invariably there will be disagreements or different perspectives on how best to accomplish that goal. These decisions are often viewed by some as detrimental to the community, while others may conjecture South County Health is simply attempting to maximize profits.

These assertions are being made without context by those who do not understand the measures South County Health’s administration took prior to arriving at what are often difficult decisions. We value the input of our physicians, staff, and community members. Open communication and collaboration are critical to our success, and we are committed to fostering a culture where all voices are heard and respected.

There are avenues available for those who disagree to voice their concerns and they are entitled to a respectful hearing. One such avenue is an upcoming YouTube Live Community Forum on September 16 where our leaders will be answering questions from the community. 

South County Health must continually assess how we provide healthcare services to ensure our enterprise remains sustainable, and we continue to provide the highest quality of care for our community. The successes of our efforts has been validated by our recent recognitions by the Centers for Medicare and Medicaid Services (CMS) as a 5-Star Overall Hospital for Quality, our “A” rating from Leapfrog Hospital Safety Grade, our renewal of the prestigious Press Ganey Pinnacle of Excellence and the Guardian of Excellence awards for exceptional patient experience, and staff turnover rates that are below regional and national averages.

However, many of these difficult decisions may not be easy for the community to understand. We are asking for ongoing dialogue and to some extent, the benefit of the doubt before rushing to judgement or sharing misinformation that is a detriment to the community. Our unwavering focus is on ensuring the highest quality of care and the sustainability of our health system for the community that we are honored to serve. No matter the challenges we face, our true north remains the well-being of our patients.

In addition to the responses to each individual assertion (attached), we encourage you to visit the landing page that was recently launched that offers additional insights into the current state of healthcare in our state, as well as the truth behind recent organizational changes. 

However, during the Hematology staff walk out, they did respond with these statements: “South County Health remains committed to providing and growing comprehensive community cancer care for the residents of Washington County and beyond.  This includes the same elements of medical, radiation, and surgical oncology, along with supportive and ancillary services, we have always offered. We believe this is critical to South County Health’s mission of being Rhode Island’s Most Trusted Health Partner. As an organization, we refrain from discussing specific personnel matters publicly. It is not uncommon for personnel changes to occur within an organization of our size. When providers leave for any reason, we have comprehensive strategies in place to ensure that patients continue to receive safe, high quality care.

South County Health is deploying three new hematology-oncology physicians for coverage to the Cancer Center. These new physicians will be starting at South County Health’s Cancer Center around early- to mid-October. All new physicians will be added to our medical staff following applicable policy and procedure. This deployment intends to ensure all Cancer Center patients have continuity in their care.”

This is a developing story