Hospitals: crisis in leadership
What impact does the quality of a board of directors, selected by voters, have on the quality of care at public hospitals? It turns out it matters a lot. An analysis of hospitals in North San Diego County shows how decisions made at the ballot box can have a huge effect on a hospital’s success or distress.
What impact does the quality of a board of directors, selected by voters, have on the quality of care at public hospitals? It turns out it matters a lot. An analysis of hospitals in North San Diego County shows how decisions made at the ballot box can have a huge effect on a hospital’s success or distress.
North County's two flagship public hospitals are locked in a fierce business struggle, with Tri-City Medical Center losing money and patients to competitors while Palomar Medical Center surges ahead, a North County Times special report shows.
Though they do the same kind of work as other hospitals in the region, North County's two main medical centers sprouted from vastly different roots.
Unlike most for-profit and nonprofit hospitals in San Diego County, Palomar Pomerado Health and Tri-City Medical Center are state-chartered public district hospitals, created decades ago by a majority vote of the communities they serve.
California's network of district hospitals is the product of a turbulent era, when troops returning from World War II needed acute care, especially in low-income rural areas where hospital beds were scarce.
A state law passed in 1945 gave local governments the authority to raise taxes to build and manage hospitals and other health care facilities.
As the feverish flow of news about major North County medical institutions rattled patients and doctors, the North County Times and the Center for California Health Care Journalism turned to the data to check how Tri-City Medical Center and Palomar and Pomerado hospitals served their communities.
The bed-bound patients at Tri-City Medical Center last Thursday afternoon could not have suspected the acrimony breaking out downstairs on floor L-L.
More than 200 doctors, nurses, aides and local residents crammed into a basement assembly room of the Oceanside hospital, most of them there to issue a challenge to the public district hospital's troubled board of trustees.
Each of the two boards that set policy for their respective hospital districts has seven elected members. In each district, board members are elected to four-year terms.
A Hollywood casting director in search of a revolutionary would not turn first to Dr. Richard Burruss, Jr.
The earnest-faced Tri-City Medical Center emergency physician, with his soothing voice and Stanford degree, seems ready-made for the lead role in a modern-day "Dr. Kildare," not "Che."
Throughout several careers, and especially in his current role as chief executive officer of Tri-City Medical Center, Larry Anderson has relied on the contents of his rolodex to get things done. But he has also shown a willingness to scuttle diplomacy and simply attack.
Both supporters and critics say that insight into the personality and management style of Michael Covert, the charismatic chief executive of Palomar Pomerado Health, can be gleaned from the battle over where to locate the new Palomar Medical Center.
When the towering new Palomar Medical Center opens in early 2012 on an Escondido hilltop, visitors to the top floor will be able to gaze 19 miles west past Vista, Carlsbad and Oceanside to the sea.
That landscape is fast turning into a health care battleground as the region's three largest hospital systems fight for the hearts and pocketbooks of potential patients. At stake: the shape and quality of health care for North County's 860,000 residents.
While local hospitals compete to lure insured patients in well-off areas such as Carlsbad, the recession is leaving more and more residents without jobs or health insurance.
Anyone curious about local health care trends need only cruise along the boulevards of eastern Carlsbad to find some telling clues.
This was one of three cities that banded together in the 1950s to found a public hospital district and create Tri-City Medical Center in nearby Oceanside. Today, the 100,000 residents of the well-off coastal community are still among the voters responsible for electing the hospital district's governing board.
But when it comes to patient loyalty, all bets are off.
Orange County Treasurer Chriss Street, in a letter made public Tuesday, tells county supervisors he will not pursue a proposed loan to Tri-City Medical Center.
After nearly one year of financial frustration, Tri-City Medical Center appears to have found a willing bank to help the public hospital refinance $53 million in long-term debt.
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