‘The odds are 50-50.’

That’s generally not what you want to hear from your doctor.
Yet that was one of the professional opinions expressed at the Sonoma Valley Health Care District Strategic Planning Committee meeting last week, in an exchange that featured frank assessments of the prospects for health care in Sonoma Valley.
New committee chair Alden Brosseau posed to hospital CEO Carl Gerlach the question of the likelihood that the present plan to develop a replacement for the failed Health Plan of the Redwoods actually would succeed. That plan is to create a group of providers and/or facilities large enough to 1) realize efficiencies in operation, 2) create a large pool of patients to attract participation by physicians and 3) negotiate favorable reimbursement rates with insurers.
Brosseau asked for the likelihood of success on a scale of 1 to 10; Gerlach pondered for a moment, and then said, “5 and a half.” Committee member Joe Smith, M.D., specifically representing the Marin IPA (independent practice association), to which all 16 of the family practitioners in Sonoma belong, called it “50-50.” Health care district board member Dick Kirk, M.D., who is also president of the very joint powers authority created for that purpose, said he would give it a 70 percent probability of success. Three district hospitals – located in the towns of Sonoma, Sebastopol and Ft. Bragg – have signed onto the JPA.
Thus, there is a considerable possibility, in the range of 30 to 50 percent according to several of those closest to the situation, that Sonoma Valley Hospital will not be successful at forming or joining a larger organization in order to ensure its survival beyond, say, 2014. That is the outside window that Gerlach quotes for the survival of independent district hospitals, like ours.
Diagnosis: No clout, and losing market share. Prognosis: three to five years.
Wow.
Many Sonoma residents will recall the “Plan B” grass-roots efforts in 2006, following the failure of voters to approve the Measure C bond to build a new hospital facility on the Leveroni property on Fifth Street West. Maybe, just maybe, it’s time now for “Plan C.”
At the least, the strategic planning committee should start, as its name implies, to strategize for the very real possibility that they will fail to preserve the hospital as a viable enterprise. Gerlach and Kirk are pursuing that path with great diligence, but it is filled with political and practical potholes.
Kaiser Permanente is the big player in the field in Northern California, a health care giant in which 25 percent of Sonoma residents are already participants, and that number is growing. Maybe, just maybe, the committee should investigate whether Kaiser would be interested in acquiring Sonoma Valley Hospital. Is Sonoma’s hospital attractive to that company? Can that even be done, given our public ownership and management arrangement? And if not Kaiser, then who?
The refrain has been heard for years: “We must affiliate.” It should be a drumbeat, now, as the alternatives, frankly, look bleak.
Local emergency medical services are an essential part of what residents expect in Sonoma Valley. In our view, our elected and appointed leaders should define a back-up plan for the preservation of that vital function.