ACH critical to county’s future

Editor’s note: This is the final of three articles written about rural health care.

Register Editor

Register/Bob Johnson (at left) and courtesy photo (at right)
A room in Allen County Hospital, at left, though neat as a pin, is small, making it difficult for medical personnel to navigate equipment around a bedside. For comparison’s sake, hospital rooms at Neosho Memorial Regional Medical Center in Chanute are more spacious for staff and for visitors.

Showing new recruits a 57-year-old hospital makes for a tough sell, admitted Joyce Heismeyer, chief executive officer of Allen County Hospital.
“Aesthetics and patient flow are problems,” Heismeyer said of two glaring deficiencies with the facility. “It would take some serious gutting and face-lifting to make it right. The basic structure is sound, but it is just not the right design for today’s needs.”
Is this a turnoff to prospective physicians?
“Unless we get a new hospital, we’ll have a very hard time recruiting new physicians,” said Dr. Frank Porter of the Osborn Clinic in Colony.
In a wide-ranging interview with the county’s seven physicians, all agreed with Porter and with his assessment: “Are we nervous for the future of health care here? Yes.”

THE HOSPITAL’S future lies with two entities.
First with Allen County, which owns the hospital and has the responsibility of seeing that it meets the needs of its citizens.
Second, the Hospital Corporation of America, which leases the building from the county and manages its operations. Under the arrangement, HCA bears the risks and reaps the profits from the hospital.
HCA is the largest chain of hospitals in the United States. Based in Nashville, Tenn., it primarily owns and manages metropolitan hospitals with hundreds of beds. Iola’s 25-bed facility is an anomoly for HCA and a reason why its needs don’t rank high with corporate leaders.
That said, Heismeyer assured that HCA would be “willing to investigate what it would cost to build a new facility or to bring the hospital up to snuff” with a major renovation if county officials were serious about pursuing it.
Building a new hospital or doing a massive renovation both have arguments in their favor.
Building anew would allow for greater efficiencies, but most likely be “maybe two-thirds” the size of the current hospital, Heismeyer said.
A major renovation would result in “more square footage for the money,” Heismeyer said, but the current site is “landlocked,” and would not solve longstanding problems of traffic around the hospital or make it possible to add on other services.
Heismeyer said improvements to Chanute’s Neosho Memorial Regional Hospital, where “they literally made something new out of the old,” is a good example of what Allen County Hospital could do.
Financing such capital improvements would be the county’s responsibility.
To date, county commissioners have not met with hospital administrators to discuss building or remodeling.
Heismeyer hesitated on her answer that something of the sort is in the cards.
“I don’t know. And I know that’s a really bad answer. HCA would certainly want to work with the county on a model that would work, but it doesn’t own the hospital. Saying that this is something that HCA should finance is like a landlord asking a renter to build him a new house while he still takes in the rent. Are you going to want to build a new building that you don’t own?”
“HCA would certainly want to work with the county on a model that would work. After all, it’s in both of our interests that the hospital thrive,” she said.

BESIDES a new hospital, other ways exist to attract new doctors to the area, said Heismeyer, including targeting recruits interested in practicing in a rural location.
Those candidates include those who “tested the waters of a city” and are ready to return to a small town; those who are winding down their careers and would like a slower pace; and those who during their residency program worked at a rural practice and liked it.
The latter example is how Drs. Tim Spears and Wes Stone ended up in Iola when they did their obstetrics rotations at ACH. Both were students at what is now the Kansas City University of Medicine and Biosciences where they became doctors of osteopathy. Porter also attended medical school there while Drs. Brian Wolfe, Becky Lohman, Glen Singer and Dan Myers attended the University of Kansas Medical School. Dr. Earl Walter received his degree of osteopathic medicine at the Kirksville (Mo.) College of Osteopathic Medicine.
Another way to attract new physicians and have a busier hospital is to have specialists in fields such as cardiac, orthopedics, or pulmonology establish part-time practices with Allen County Hospital as a base.
The presence of Myers as a resident surgeon has made a big difference to the hospital patient count and to the primary care physicians, Wolfe said. “We need more like him so our patients don’t have to be transferred out of town.”
The hospital currently has specialists in cardiology, ophthamology, podiatry, neurology, oncology and an ear, nose and throat specialist who routinely visit, Heismeyer said.
“But we desperately need an orthopedist and someone in pulmonology,” she said. Allen County could keep an orthopedist plenty busy, Heismeyer said.
The nearest orthopedists area physicians refer their patients to are in Parsons, according to Wolfe.
The benefit to visiting specialists is that the patients they see here often use them when they need more major procedures performed. Dr. Greg Duick, a cardiologist who’s been coming to Iola twice a month for 30 years, for example, has a steady stream of area patients who seek his care at the Wichita Heart Hospital when they need procedures such as heart catheterizations performed.
“Our big worry is getting specialists to come and support us locally,” said Myers.
Having an orthopedic surgeon in-house, would bring major benefits to the local medical community and hospital, Wolfe said.

HOW BIG a turnoff is ACH?
“It was a disappointment,” said Lohman, who moved to Iola in 2007 to practice with Drs. Wolfe, Singer and Spears at The Family Physicians. “But at the time we were scouting out locations, I was more interested in what my experience would be at the clinic and I really didn’t pay much attention to the hospital.
“I didn’t even meet the hospital administrator, (then Mike Ellis) until we had already moved here.”
Coming from Chanute, Lohman said “I was accustomed to a hospital always building, renovating and marketing its services. It’d be nice if the county gave Joyce (Heismeyer) more support and direction as to what could be done.
“I’m young enough that I have hope that eventually things will get better and improve. I can’t believe the county would let the hospital get so bad that it would just go out of business.”
Some parts of the hospital are in worse shape than others.
In his 25 years of practice, Wolfe said the obstetrics department “still looks the same as the day I arrived.”
As a physician who still delivers babies, Spears, 50, said if he were a new recruit weighing the differences between the hospitals at Iola and Chanute — “I’d have to go with Chanute,” citing the priority Neosho Memorial has given to that area of its physical plant.

HEISMEYER HAS hope for the hospital’s future. And while she sees her role as a player, she said it’s going to take a team to make it happen.
Getting more people on board to promote hospital improvement is essential, Heismeyer said.
“What I really love about organizations like Thrive Allen County is that they work to build the county up, not only by trying to counter the loss of population, but by truly turning things around.
“We all need to be thinking about what we can do to make this a community of growth. For the next five to 10 years, we’ll be OK. But thinking 20 years down the road it gets scary. How long can we continue losing population, year after year?
“Part of my role, and everyone’s, is to see what we can do to make our schools, hospital, business and industrial community better so that we have an attractive place to live. We haven’t done it yet, but in the one-and-a-half years that I’ve been here, I’ve seen lots of activity across the board for wanting to make the county better — a goal which should include a new hospital,” she said.