My name is Richard Haskell, M.D. I was the Chief of Staff of the Hoag Hospital Medical Staff from 2015-2018 and am now part of the Medical Executive Committee as the Immediate Past Chief of Staff from 2018 through the end of the year. Next year I will represent the community as a member of the Hoag Hospital Board for the following three years. I have had a front row seat to the challenges Hoag has had over the last several years during our affiliation with Providence.
About 250 years ago, our country was battling Great Britain over independence. In 1776 we did not want to be controlled by a large, far-away entity that did not have true American spirit and values. Today, Hoag Hospital is fighting a similar battle against the “tyranny” of Providence Health Systems. We want to “call our own shots” without having to ask for permission from a corporate entity based in Seattle with 50 other hospitals throughout the Western United States.
Hoag wants to be “nimble and quick” when it comes to making the best medical care decisions for our patients. This is hard to do when you have to get “permission” from 50 other hospitals who are only looking out for what is best for their hospital or the “system,” but not our hospital, our community, or our patients. If we feel that there is a better way to care for our patients, we need to adopt that change as soon as possible. However, we are often hindered because now, Hoag must use the Providence Electronic Medical Record (EMR) system. We cannot control that system and need the permission of the Providence Administrator. That oversight process can take months or even years to enact. We need to control our own EMR so that software changes can be made quickly – lives are at stake!
Hoag Hospital has an outstanding reputation that exceeds most other hospitals (see https://health.usnews.com/best-hospitals/area/los-angeles-ca). Hoag is the highest ranked hospital in Orange County, #4 in Southern California and 8th of the 344 hospitals in California. We are highly ranked in multiple specialties and procedures/surgeries. Our goal is to be in the top 10 percent of hospitals in all categories, nationwide. We do not want to be the same as 50 other hospitals and be considered “average.”
Thanks to the generosity from the contributions of our community, Hoag can afford to deliver the highest quality of care to our patients. This includes cutting edge doctors, procedures, surgeries, equipment and medicines. Hoag is fiscally sound, while Providence has recently been struggling and has been cutting resources, including clinical staff, that could ultimately adversely affect patient care.
I have already given examples of physicians having to fight Providence to provide high quality care. I am currently trying to get a medicine into the hospital formulary that acts as an “antidote” to the newest anticoagulant medications that you have probably seen on TV and the Internet. Although it is expensive, it can be potentially life-saving. So far we have been blocked from getting this by the “system” at Providence, but we will fight on and the hospital administrators at Hoag will continue to back up the doctors on this important point. Why should we have to fight a multi-state system for what is right for the patients we serve in our community?
Another example is that Hoag had a commitment from a local donor to supply rapid turn-around COVID testing equipment in April when the supply was very limited. Providence blocked the procurement of these tests stating that Hoag would have to share these resources with the other 50 hospitals under Providence, spreading the donation too thin to make a difference.
Contrary to what some have thought, this is NOT a fight between Hoag and St. Joseph’s Hospital or Mission Hospital. In 2012, Hoag voluntarily entered into an alliance with St. Joseph’s, Mission and St. Jude to adopt a “Regional Health Care” system. This made sense because we thought we could all align for better care of the Orange County patient population. At that time that alliance did not interfere with each hospital’s ability to provide autonomous hospital care. But in 2016, Providence bought St. Joseph’s Health System without Hoag being aware or being consulted.
Hoag was not bought by Providence, but Hoag now found themselves aligned due to the original contract with St. Joseph’s. As the alliance continued, it morphed into attempts to control and dictate care at Hoag by Providence – which had NEVER been done during the St. Joseph’s alliance. We are aligned but NOT owned by Providence. In order to provide the best care for our patients, the alignment must be severed. The physicians at Hoag Hospital are asking for the support of the community as we battle through the legal process.
Richard Haskell, M.D., is Board Certified in Internal Medicine and Cardiovascular Diseases for Newport Heart.
To view the original Stu News Newport article, please click here.
