Opinion: Physician reflects on sense of shared loss after HCA bought Mission Hospital

I first walked into Mission in 1980 to begin my training at MAHEC as a resident in Family Medicine.

My classmates and I had just taken the Hippocratic oath promising to uphold ethical standards, the art of medicine, and act in our patients’ best interest. It called on us to remember that we were now members of society with a special obligation to all our fellow human beings.

Mission was a relatively small community hospital. It was where the indigent or those without choice would go for care. St. Joseph’s was a private facility, admissions were generally elective. Mission was a safety net anyone could count on. There was a shared sense of pride in caring for any and all, no questions asked.

Only in the previous 10 years had the community started to attract the very best physicians out of their training programs. There were limited numbers of all the specialists. Every physician or group admitted their own patients, making rounds in the morning before going to the office, often again at the end of the day. Returning after hours and through the night was the norm.

Mission was home away from home for all of us. We were there to meet the community and region’s needs. It didn’t need to be advocated for. The mission didn’t need to be defended.

We were building a medical community defined by trust, collegiality and excellence. Physicians were in leadership roles across the board, working with hospital leadership to prepare for what was around the next corner. We were all committed to providing the best care possible. Our relationships supported that end.

For members of the community, working at Mission or St. Joe’s was something to aspire to, a place to have a career, a place to belong, to feel proud of. There was a sense of ownership for them as well.

Mission, over decades, grew in stature and reputation. Physicians from the most prestigious programs in the country wanted to come here. The growth and excellence that resulted was hard earned, built by the commitment and sacrifice of countless physicians, nurses and so many others.

Mission defined who we were as a community. It was where we shared a sense of meaning, where we had history, a voice, and where we could all strive to be the best we could be.

Sense of loss for physicians, patients, community

There’s a deep sense of loss so many of us feel since HCA has taken over. Their corporate-driven changes are not only antithetical to our way of being, they dismantled what we’d worked so hard for. They’ve erased our institutional memory.

The community and region have experienced a sense of loss, too. Patients have lost experienced providers or services. There’s been a loss of confidence and the security of care we’d come to expect. They’ve erased community memory as well.

The exodus of physicians is one marker of this loss. Practices have been forced to make difficult HCA-driven changes. Physicians employed by Mission have had no choice but to accept the HCA way or leave. The fear of retribution makes it difficult if not impossible for many to advocate or speak up.

Issues related to patient safety and quality of care have been front and center, as they should. Space doesn’t allow for these to be recounted. They are well documented.

HCA brought with them a culture that has undermined trust, alienated many and harmed the collaboration and collegiality that’s defined who we’ve been. Their manner has been marked by a lack of respect for the ethic and shared purpose that defined our health care community. We’ve had what feels like a hostile takeover.

The staff at Mission are doing heroic work and deserve our highest respect. Outstanding care may be more the norm than appears thanks to their dedication. I've witnessed it. The corporate-driven problems are not on them. Please express your gratitude every chance you get.

We should all want stewardship of our health care system to be in the highest service possible to all the residents of Western North Carolina, not to HCA shareholders and executives. We deserve excellence in care across the board supported by the services and resources we once had. Quoting a nurse leader, this is a manufactured crisis. HCA has plenty of money to restore the excellence we’d come to know.

We deserve better than the quality of our health care being publicly traded.

More: Opinion: What would heart surgeon Charlie Keller say about Mission Hospital today?

More: Opinion: Mission Hospital used to have world-class cancer center; that changed with HCA

Dr. Bruce Kelly is a retired Family Physician who provided care and served at Mission for over three decades. He completed his 42-year career at the Charles George VA Medical Center.

This article originally appeared on Asheville Citizen Times: Opinion: Physician says HCA Mission purchase is like hostile takeover