Letter to the Editor - The problem with Calais Obstetrics

To The Editor:

I am a surgeon and a Family Physician who has practiced in eastern Washington County for more than thirty years. I have also served for extended terms on the boards of local hospitals, although not Calais Hospital. Additionally, I have been deeply involved in the issues of health care services with a national surgeon organization for more than ten years.

Unfortunately, as it has advanced, health care has developed and extensively advertised more "high tech" specialized services. Especially with due to these services , overall health care costs have sky-rocketed.

Even thirty years ago, Obstetrics at Calais Regional Hospital was an entirely under-used service. Other more greatly used services helped to carry it. Not only for Obstetrics, but for all health care requiring hospitalization. I repeatedly encountered frequent unwillingness my patients to go to Calais Hospital (and down east in Machias as well). It was not an issue of dislike, they “loved” their hospital. It was always their concept of “good” care... surely available in Bangor but not so surely in Calais. We, all of us, are buffeted daily by information from all directions touting "high tech" as the standard to be sought for health care...and usually, it is assumed as gospel, not available in Down East Maine.

This attitude lures patients away from hospitals like Calais and into the "high tech" tertiary care centers. Interestingly, many of these patients not really needing "high tech" care are filling beds needed by patients who do require "high tech" but are forced to wait, often disadvantageously, for a bed to become available. The care provided to a non “high tech” patient could be provided at hospitals such as Calais or Down East. The managers of hospitals such as EMMC in Bangor are now trying to devise ways to convince the "low tech" patients to stay in the outlying hospitals for their care.

The so called “low tech” hospitals are qualified and equipped to provide a great array of quality health care to patients. They cannot, however, if the patients elect to go “up the road.”

The problem with Calais Obstetrics is simple. Maintaining the personnel and the equipment needed to provide safe , quality obstetric care is very expensive. It drains the financial resources of the hospital if it is not being used and generating reimbursement. Unfortunately, it also drains resources if a significant number of the patients who are served in obstetrics have no means for paying for their care... a fact for a high percentage in rural locations such as ours. 

The Calais Regional Hospital Board of Directors is not ignorant or uncaring. It is prudent, as the law requires it to be. The situation at Calais OB could be reversed, but it is unlikely. The solution would be to convince insured pregnant patients to remain at Calais for their routine pregnancy and delivery needs. Even better would be for local residents to stay at home to have their hospital care which does not require tertiary services...your providers can help you to know which is which. Unfortunately, currently few now do. Our present problem was succinctly expressed many years ago in a cartoon by Pogo: “We have met the enemy and (they) is us.”

If you want local OB service, if you want to continue to have a local hospital, many more of the local citizens, especially the insured, have to use it.

Charles T. McHugh