The Closure of CRH Obstetrics Likely

By Amy Jeanroy


The news that the board of the Calais Regional Hospital is considering closing the Obstetrics department shocked and alarmed the Downeast community. Social media  calls for protests, and indignation that the OB department was chosen before another, created an atmosphere of anger toward the administration. 

 A protest is planned for Tuesday afternoon, and administrative contact information was shared on social media, asking community members to call/e-mail their feelings hoping to change the outcome. 

It's so much more than a simple decision, says hospital CEO, Rod Boula. 

The hospital is a cornerstone of the Downeast community. It has been here for such a long time that any change seems catastrophic. However, like any business, the hospital has to always look at their numbers to find ways to keep operating. 

According to Boula, he and the board are trying to develop a niche for the hospital due to the changes in healthcare as well as changes to Washington County and how residents use the hospital. Ten years ago there were 119 babies born at CRH. It would take 180 births to break even with the costs of keeping the OB department open. Last year there were 60 births at CRH, and they are on track to do about the same for 2017. The cost for the on-call portion of the program is close to one-half of a million dollars. If you divide that number by 60 babies, it's close to $9,000 per baby. And that is just for the on-call portion not the actual delivery costs. 

“Our margins are shrinking in other departments, like our lab or surgery. Other larger hospitals have more volume and larger margins. These margins help offset losses in other departments, and we just don't have that.” Says Boula. 

It's not just the actual cost of the births being so high spread over the low numbers; the problem is women choosing to have their babies at other hospitals. According to the numbers of births in our community, women are already going elsewhere for their OB needs, travelling to Machias or Bangor to give birth, not Calais. 

Add to this, the reduction of the number of people living in Washington County and the general aging of the community. The socioeconomic factors including family sizes also affect how many births happen at the hospital.

Boula says it's a matter of “Use it or lose it. We are no different than other local businesses. Over the years, businesses leave when locals don't use the services.”

Calais Regional Hospital is losing $5,000 a day as a business. We have to stop the bleeding in some way or another. The Board's decision is not being made in haste. According to Boula, the idea has been talked about at the board level for 20 years. 

When asked about the future which impacts women's health so deeply, both Boula and CRH Community Relations, Dee Dee Travis say that the hospital is working on solutions. 

"We aren't looking at elimination women's health at all. We are looking to augment as best we can. We are looking at other groups who may be able to come here to provide these services. For example, maybe folks from Downeast (hospital) can come here to regularly and see clients. We are recruiting for Primary Care doctors. Our ideal candidate would be a Family Care doctor who also offer gynecological services.”

Also, many of our current providers can provide many things such as annual women's exams and that sort of thing. says Travis. 

Another example of an underutilized service that CRH provides is their state of the art mammography unit. According to Boula, the number of people who use the service is much lower than the percentage of people who should be using the service. Where are they going? Are they heading elsewhere or just not getting the care? 

“We still firmly believe that Calais Regional Hospital has a strong future here, but not trying to provide all things to all people. The community needs to do their part by utilizing the hospital for any of the services we do provide. We need to have more people when they go elsewhere to say they want the care that is available in Calais to be given in Calais."

Boula says  “We don't want to compromise the care. We want to improve the access.”

“Our community tells us what services they want us to provide. We have the numbers that tell us what services the community needs and which ones we should provide. The community tells us what they want us to provide by coming here and using those services.” says Travis.

One of the most important things to the board and the leadership at the hospital, says CEO Boula, was that if the OB department does close, no one in the department would lose their jobs. All staff would be reabsorbed into other departments. 

If the Board approves the closure tonight at their meeting as is projected, the OB Department will remain open until January 1, 2018.