September 11, 2008 Issue                                       

©2007 The Chestnut Hill Local

Hospital CEO defends closing of obstetrics
by JOEL HOFFMANN

Chestnut Hill Hospital CEO M. Brooks Turkel believes he made the best decision for the community in closing the hospital’s obstetrics unit, but he understands the pain behind the numbers.

“This is the right thing in terms of our ability to be able to serve the community,” Turkel said. “But it doesn’t seem right, and I know it doesn’t feel right to [the] caregivers who dedicated their lives to serving this community, and there’s nothing that they could’ve have done differently that would have made a change, and that’s frustrating to them.”

Although the hospital is financially stable overall, the maternity care and neonatal intensive care units are running up a $2.5 million deficit each year, according to Turkel. He recognizes the need for high-quality obstetric care in Chestnut Hill, but he said demand for the services was too low to justify keeping the units open.

The hospital averages 1,000 deliveries a year, according to Turkel, which is less than 3 percent of the 35,062 births reported last year in Philadelphia County.

When Chestnut Hill Hospital closes the obstetrics unit on Nov. 7, it will become the 15th regional hospital to take such action since 1997. Turkel cites high-tech equipment costs and six-figure malpractice insurance premiums among the causes.

When asked for further comment, Turkel did not respond to questions about the role of Medicaid in his decision-making.  Forty percent of the hospital’s maternity patients come from Germantown, where about 25 percent of the population lived below the poverty in 2000, according to a U.S. Census report. More recent poverty statistics for Germantown are not available.

But Turkel thinks that nearby hospitals like the Germantown branch of the Albert Einstein Medical Center and Abington Hospital will be able to absorb his hospital’s maternity patients.

Einstein is expanding its maternity unit in response to a 40 percent increase in deliveries since 2002.  But spokeswoman Alexis Moore could not say how many Chestnut Hill Hospital maternity patients Einstein could accommodate.

The closing will also send at least 70 hospital employees — mostly nurses — looking for a new place to work. Turkel said the hospital would hold a career fair for those employees. Even in a tight job market, nurses shouldn’t have much trouble finding a new job because there is a nurse shortage, he said.

Of the five obstetricians on staff, two are expected to stay on as gynecologists. Three doctors, five full-time midwives and four part-time midwives will likely search for work elsewhere, according to Dr. Paul Neumann, interim chairman of obstetrics.

Neumann said the nurses should have an easier time moving into general practice than midwives or obstetricians, but he doesn’t think the transition will be easy, and he’s not sure how many opportunities exist. He has a few job offers on the table himself, including one to specialize in gynecology at the hospital’s Blue Bell office. But the future remains uncertain for him — even after 18 years with the hospital.

“It’s a sad time for Chestnut Hill,” he said.

For some opponents of the closing, sadness has turned to anger.

Cindy Bass, an aide to Congressman Chaka Fattah (D-2), described the closing as “outrageous.”

“To say we have health care available at Abington or Einstein is unacceptable,” she said. “It’s not a choice. So many low-income women and children use the {Chestnut Hill] hospital on a regular basis.”

State Sen. LeAnna Washington (D-4) called it a “tragedy.” She said she felt that Turkel deceived her.

“He assured me that all persons would be relocated in other positions,” she said in a statement. “I am always disappointed when people come into our community under false pretenses.”

Washington said that Turkel had told her last year that the unit would stay open. For his part, Turkel said that he had tried to keep the unit open but that the financial circumstances had changed.

Turkel said he wants to redirect resources toward treating heart disease and cancer, the two leading causes of death among women.

The University of Pennsylvania Health System offered to cut maternity costs by redesigning the unit’s management structure, but Turkel turned down Penn’s offer to keep the unit open, according to Neumann.

A public forum on the closing was set for Sept. 9 at 7 p.m. By that time, the Local had already gone to press.

When news of a potential closure broke last year, 50 people held a protest outside the hospital.