A recent decision made by Dartmouth-Hitchcock Manchester to partner with the Catholic Medical Center instead of Elliot Hospital for obstetric care has drawn criticism from Elliot about the effects and underlying motives of the decision, according to Doug Dean, president and CEO of the Elliot Health System.
Elliot recently published a full-page advertisement in the Manchester Union Leader in the form of a letter drafted by the doctors and nurses in the obstetrical unit at Elliot, Dean said. The letter raised concerns about CMC's lack of a neonatal intensive care unit and the effect of CMC's religious affiliation on patient care.
These issues led officials at Elliot to question why DH-Manchester aligned itself with CMC and in turn diminished its privileges at Elliot from "active" to "associate," a change that will come into effect on July 1, according to Dean.
"[The decision] has nothing to do with concerns relative to quality or clinical improvement," Dean said. "It has everything to do with corporate concerns. The patients shouldn't be utilized as pawns in a corporate relationship."
Dave Evancich, vice president of public affairs and marketing for DHMC, said that Dean's statement about corporate motivations is "just not true." Because of CMC and DH-Manchester's growing professional relationship, CMC is a "stronger option" to provide obstetric care, according to Evancich.
"Dartmouth-Hitchcock and Catholic Medical Center have a record of collaboration that better serves the health care needs of our patients," a joint statement from CMC and DH-Manchester read.
With its neonatal intensive care unit, Elliot is more capable of providing emergency care to babies, Dean said. Elliot has the largest obstetrical care unit in New Hampshire and its NICU has operated for more than two decades, according to Dean.
"It's estimated that about 15 percent of births require neonatal service," he said. "Our concern relates to the fact that you can't foresee problems [that require neonatal intensive care]."
Neonatologists at Elliot can support delivery and intervene if there are unexpected difficulties, Dean said.
Evancich said that DH-Manchester's decision will not put any patients at risk and that transfers to Elliot for neonatal intensive care would not endanger patients.
"The OB-GYN department and physicians [at Dartmouth-Hitchcock in] Manchester would not have gone along with any changes that would have put the patients at risk," Evancich said.
Ultimately, individual patients will be able to choose between delivery at CMC or Elliot regardless of DH-Manchester's official affiliation with CMC, Evancich said.
"The patients and families and the mothers will still certainly have a choice," Evancich said. "[We were] disappointed to see some of the inaccuracies about choice [in Elliot's advertisement]."
CMC and Elliot had been merged at one point, but broke apart because of ethical and religious differences, according to Dean. The "environment dominated by religious directives" at CMC may interfere with patient care, he said.
"We're not suggesting for a moment that CMC doesn't have the right or the ability to deliver a baby," Dean said.
Dean said that some patient services, including tubal ligation a surgical sterilization process used by women who no longer want children are not performed at CMC because of the institution's religious and ethical opinions.
"Our obstetricians and nurses don't want to see Dartmouth-Hitchcock and their patients caught in the cross-fire of debate between ethical and religious directives," Dean said.
Dean raised concerns about the overall level of care in the Manchester community as a result of the decision, noting that the possible loss in volume of care at Elliot could change the cost and quality of care in the region.
Evancich said that he felt as if the decision made by DH-Manchester will have an overall positive impact.
"Overall, we feel that the way we utilize physicians in the community will improve care," Evacich said.
Elliot was initially informed of DH-Manchester's plans through an informal discussion between a DH-Manchester physician and Elliot nurses, a precursor to what was supposed to be an official announcement, according to Evancich. Dean said Elliot has not received a formal notification of the decision, however.
Dean said that the relationship between Elliot and DH-Manchester "was very positive" before the announcement, noting that the chair of the OB-GYN department at DH-Machester has worked at Elliot for over two decades.
