The Southern Mono Hospital District Board made its temporary cessation of Labor and Delivery services permanent on Tuesday evening at a special meeting held in the hospital’s conference room.
The vote was 3-1, with Board members Dr. Yuri Parisky, Alec Clowes and Laurey Carlson voting for, and Board member Rian Wood voting against.
Mammoth Hospital had temporarily shuttered its Labor and Delivery department in January, 2022, citing staffing issues.
At the time, the department was losing approximately $1.2 million annually and had experienced a drop in business volume during the pandemic.
Historically, between 2014-2018, about 100 babies had been delivered annually in Mammoth. That figure declined 40% by 2021. And as Parker stated, “Our [local] childbearing population is projected to decline 7% over the next twenty years.”
Northern Inyo Hospital has picked up the slack since January 2022 and is projected to deliver approximately 215 babies this year.
As Hospital CEO Tom Parker said during his presentation, “We need eight full-time nurses to staff the unit, and despite recruitment efforts, only one legitimate candidate had stepped forward over the past 18 months.”
The plan moving forward is for Mammoth to coordinate with Northern Inyo on Labor and Delivery, transitioning patients to NIH care at 28 weeks.
Natalie Chapman will facilitate in this area as Mammoth’s “Women’s Health Navigator.”
Former Mammoth Hospital CEO Gary Myers made an impassioned plea to save Labor and Delivery, which he considers an essential service. “Deleting an essential service should not be taken lightly,” he said. “We pushed very hard to reinstate Labor and Delivery 25 years ago, and it’ll be very hard to ever get it back if you close it permanently.”
What Myers really seemed to be cautioning against was being too eager, too rash: “Locally, we are addressing housing issues. And there are good odds of local population growth [disputing Parker’s projection regarding childbearing population].”
He also said it’s well-documented that Moms generally make healthcare decisions for their families. “This may not play well [with local women],” he warned. “They may think you don’t care about them.”
Myers’ daughter-in-law Jen McMahon also pointed out that in the Hospital’s own 2022 needs assessment, women’s health was deemed the #2 priority. The #1 priority: employee recruitment and retention. Both these areas will take a hit with loss of Labor and Delivery.
For his part, Parker said the issue is primarily about patient volume … and safety, and how those two factors intersect.
Parker said numerous studies make a connection between patient volume and patient outcomes. Essentially: The more opportunity one has to perform a skill, the better they are at that skill.
And in rural hospitals, there isn’t as much opportunity to deliver babies.
In his comments, however, board member Rian Wood said such negative health outcomes have never occurred here. “I’m not sure I buy the [cited] stats,” he said.
“Our job is to serve the community, and this [Labor and Delivery] is an essential service,” he began. To shelve L & D, “isn’t consistent with our mission and values.”
Dr. Yuri Parisky spoke for the majority of the board, and while he didn’t use the following cliche in his remarks, we may as well use it here, because this is a health care story after all.
And what Parisky urged is for the Board to rip the Band-Aid off and make a decision. “We have been tentative,” he said. “That is part of the problem.”
And while he’s committed to an Eastern Sierra OB/GYN program, he agrees with Parker in that “fifty deliveries between two physicians … is not busy enough.”
In his own practice, he said, “I don’t do angiograms anymore because I don’t do enough of them.”
Fellow Board member Clowes said we will better serve the community by building the program at NIH.
And the 40 miles to Bishop, said Parisky, is far less than the average distance (120 miles) most rural Americans travel to the nearest hospital which offers Labor and Delivery services.