What’s Essential

The “hospital question” has been out of the news for a while, much to the relief, we expect, of the elected hospital directors. Partly it’s because the Sonoma Valley Health Care Coalition did not recommend a single site – in fact, there was no site completely in hand – and the coalition’s recommendation was to continue discussions for developing a better site at or near one of the locations considered.
We understand that those discussions are happening, and that’s a good thing. The other reason things have been relatively calm is the quiet deference to the school district, whose turn it is to put a tax measure before the voters.
But we also sense that the opportunity may have passed for a big, new hospital. Our concern has been that we continue to have some hospital here in the Valley. For a while, we believed that big and new was the only way to get that.
The problem has always been recruiting and keeping doctors. Sonoma is too small to support by itself the range of specialized practices we might like, as a community, to have here. When a surgery center was proposed, whether by Cirrus, by some other group, or by our own hospital, the idea was to bring more patients here, a lot more – enough to support local practices of local doctors.
As the present hospital CEO Carl Gerlach develops other options, though, that line of thinking may need to change. And the news from last week supports this change, with an official new agreement of cooperation among four district hospitals: Sebastopol, Healdsburg, Mendocino (Ft. Bragg), and Sonoma.
It seems now that the idea is to combine forces with other hospitals of similar size to recruit doctors into the larger pool of patients represented by the four communities. That, too, can be a workable idea, and it may be a more economical one.
Perhaps it’s helpful to step back for a moment and remember why, actually, we all are so supportive of having a hospital here. The answer is: the emergency room.
For elective procedures or non-urgent care, we may well go out of the Valley to see a specialist, or for the latest high-tech diagnostic tools. But in a medical emergency, there is no other viable choice, even for Kaiser patients. The testimonials offered during the Measure C campaign about lives saved in the emergency room were touching, and alarming, too, when we consider what would have happened without our emergency room. And we have had occasion ourselves to visit the emergency room over the years.
Remember that we would have been subsidizing the Measure C hospital at about $10 million a year, based on the cost of constructing the new facility, despite the fact that it had been projected to break even on its day-to-day operations. So it makes sense to us to consider subsidizing operating losses at a smaller hospital facility, one that costs much less to construct. That may be the less expensive option, and so may be a better way to make sure we keep what, in our minds, truly is essential: local emergency medical care.