Dan's Papers - December 21, 2007 - Southampton Hospital

A dozen years ago, Southampton Hospital's Administrative Director, John Ferry, by not paying attention to the bottom line, dropped that facility down into a hole so deep that it required a huge thirty-year loan at high interest rates from a bank to bail it out.

During the next eleven years, the Board, or what in fact was a newly appointed board, brought CEO after CEO into the mix to try and straighten the place out. None of them could. In fact, it seemed to me, as a local newspaper publisher, that many of these professional hospital administrators came on board knowing deep down that it was a hopeless situation, that they could do nothing, and so they'd come in and just hunker down, give limited access to the general public and the press, do practically nothing, and then, after a year or two, bail out with the pre-arranged golden parachute they had required in their contracts before signing on for the job in the first place.

Like many people in this community, I do not take this lightly. Southampton Hospital is our only hospital.

And so, the hospital drifted along aimlessly, it seemed to me, without making progress, and without a sense of purpose, until one year ago when a man named Robert S. Chaloner arrived on this scene to take this problem on. This man has a plan. After making some dirt fly, he hosted the ribbon cutting of the newly refurbished maternity wing two weeks ago, he and the new CMO, Fredric I. Weinbaum, went into a meeting of the local physicians a few months ago, announced a reversal of a longtime policy and received a standing ovation. And he's about to make more of the dirt fly. We're getting our hospital back.

I had breakfast with him at Danny's Poxabogue Café the other day. Mr. Chaloner was born and raised in upstate New York, the son of a father who was a doctor and a mother who was a nurse. He went to Dartmouth and received degrees in government and environmental studies. He then went to Columbia and studied public health and urban planning and got his MPH, and then received an MBA from NYU. And then he went into the hospital administration business. He is about fifty years old, an ordinary sort of guy with a mild manner. And he knows exactly what he wants to do.

Mr. Chaloner was found working as CEO at the Cabrini Medical Center in Manhattan. He had turned that place around in very short order. Somebody told him about Southampton Hospital and briefed him about the problems. "I think it's a walk in the park for you," he was told.

He said, confidently, that he thinks it is.

"I can do this," he told me.

"I accepted this challenge," he said, "not only because I think I can do this, but because of the many hospitals in trouble that need this kind of attention. This one is in the country and I wanted to move back there. I was born and raised in upstate NY and went to college in New Hampshire. I came out here and fell in love with this place." He recently purchased a home in East Hampton. He wants to remain here for a long, long time.

"What can be done about the long-term loan?" I asked.

"Not much right away," he said. "It was a lousy loan. But they had to take it or close the hospital. The terms of that loan cannot be renegotiated until 2010. But there are other ways to approach this problem."

Chaloner said that the role the hospital will play is right in front of them, and all the hospital administration has to do is grasp it.

"The State of New York is pushing all the local hospitals to take on, for complicated cases, the role of feeder hospitals to Stony Brook University Hospital, while themselves handling usual situations - and in special areas, provide state-of-the-art care. This is now about to happen, and the State is going to bankroll part of it, though that does not mean we will not need private financial help too. We are going to need a great deal of financial help."

Here is what Southampton Hospital will look like within two years.

"You will come to a 100-bed hospital and we will have state-of-the-art equipment on hand to provide quick, accurate diagnoses of whatever is wrong and take appropriate, immediate action. We will therefore have a bigger, faster and better emergency room with this new equipment - this is now underway. We will have a secondary emergency room at our new East Hampton satellite. And we will either send people off to Stony Brook or to other hospitals that are designated with specialties in the particular area of illness - or if it is in our area, we will take it on ourselves."

Southampton Hospital's area of expertise, already worked out with the State, is to be geriatrics, women's health, maternity, dialysis and rehab.

"We already have dialysis and outpatient rehab. And it's excellent," he said. "The rest is coming. We'll expand breast care, urgent care services and wellness programs. Of course, we'll continue our general medical/surgical acute care services."

In fact, maternity has already arrived, or at least the first of three stages. At the ribbon cutting, tours were given of the beautiful new maternity wing. The old wing, which featured sterile semi-private rooms with a shower down the hall and few amenities, is gone. The new wing features, after this $2 million makeover, private rooms with individual climate control, hardwood floors, full baths with emergency break-away doors, flat screen TVs, wireless Internet and furnishings that you might find in a residential setting. Stages two and three, which will provide a new operating room, new labor delivery rooms and a private waiting room, will require an additional $4 million.

As for that standing ovation by the doctors, this is what it was all about.

"Until recently our medical staff was shrinking and there were times, especially in the night, that other than the emergency room, we did not have doctors on duty at all."

"We relied, during this time and over the objection of our doctors, for doctors to be on call at all hours to come in when we needed a doctor in a particular area. They are still on call at all hours. But now we are providing them a backup. Patients will not have to wait for a doctor. And doctors will not have to come in for simple matters in off hours. We are, to put it simply, recruiting and hiring full-time staff doctors: hospitalists. In July, by hiring our sixth doctor, we will have a doctor on staff inside the hospital at all hours, 24 hours a day, 7 days a week. We intend, in a short time, to have recruited a total of twenty new doctors."

Chaloner named the new hires. They are nephrologist Dr. Claudio Martincic, breast surgeon Dr. Edna Kapenhas-Valdes, internists Dr. Candace Cummings and Dr. Elisa Santos, vascular surgeon, executive vice president and CMO/COO Fredric I. Weinbaum, geriatrician Dr. Thomas Matthew (who will be shared with the Hamptons Center for Rehabilitation and Nursing), hospitalists Dr. Cherryl Thomas and Dr. Emmanuelle Gilles, primary medicine Dr. Joanna Kluch and infectious disease Dr. Brian Bramson. They are all board certified. And they are there.

In his mind, Chaloner has compartmentalized what to do into five different categories. He is moving ahead on each of these five fronts.

One, create a leaner, newer, smaller, technically advanced and more efficient facility.

Two, insist on proper reimbursement rates from medical insurance providers. (He feels strongly that the Hospital should be paid properly for its services.)

Three, focus on affiliating with Stony Brook Hospital and the other satellite hospitals in Brookhaven, Greenport and Riverhead.

Four, build up the medical staff.

Five, in 2010 when the restructuring and refinancing of the loan can be done, be in a position to either completely renovate the entire existing hospital, or move from this location and build somewhere else a building that is more in keeping with the sort of medicine being practiced in the 21st century.

"We've already begun this study. We've designed and priced out what could be done with this late 19th century structure, and we've priced out a whole new hospital. We can do a whole new hospital cheaper and better. It would save about $3 million a year to operate. And it would be a fully green facility. If we cannot do that, though, we can do fine with the existing facility renovated."

"Where would you put this new facility?" I asked.

"It has to be right here in Southampton, so says the State. It's the regionally required spot. We are thinking of looking for a location with more parking and better access. There are a few around."

Watch for the news flashes from our hospital in the coming months. Watch this man go.