Ad-Express and Daily Iowegian, Centerville, IA

July 26, 2012

Dionne: ORHC on the right path

By Mark Newman, Courier staff writer
Daily Iowegian

OTTUMWA — The newest CEO of Ottumwa Regional Health Center anticipates so much success, they may need a remodel or expansion due to the influx of patients.

In an interview with the Courier editorial board Wednesday, CEO Philip Dionne at ORHC says he understands the challenges the hospital faces. Some problems, he said, parent company RegionalCare inherited. Other issues came when the company acquired the hospital.

“We’re the only for-profit hospital in the state of Iowa,” he said, conceding he is fully aware that makes people nervous, but that it shouldn’t.

“We charge 70 percent of what other hospitals charge,” he said, “and we’ve [done] more charity cases than Mercy Hospital [in Des Moines].”

Then there’s the $3 million in local taxes ORHC now pays.

The new walk-in clinic on the south side is now, at best, a “break-even” venture financially but was simply an effort to meet the needs of a community with a shortage of primary care doctors.

“That’s a 24/7 clinic that [sees] 25 patients a day. Even without insurance, it’s $70,” Dionne said.

That’s far less than the cost of going to the emergency department, said Suzie Wood, the hospital’s executive development director. She said the clinic is a “bumps and bruises” type of service.

Mention of the new Pella Regional walk-in clinic in Ottumwa evoked mixed reaction from Dionne. On one hand, he said, anything that brings more primary care physicians to Ottumwa is a positive thing. On the other hand, he said, some of the doctors that will be working at Pella’s Ottumwa clinic are physicians in Ottumwa, so there’s no real net gain for the community.

He said it looks like a “predatory move” on the part of the Pella group.

“I’m just baffled by it,” he said. “But I’m not losing sleep over it.”

Actually, Wood and Dionne said even with those two clinics, there has not been a decrease in the amount of traffic in the ER. In fact, though serving the community is one of the priorities for ORHC, as a for-profit business, Dionne said he is also pleased that “we are doing well financially.”

What about employees leaving or being laid off?

Yes, acknowledged Dionne, there have been positions cut. That’s how any business has to operate when they look at doing things efficiently, based upon how much work needs to be done.

Wood said before RegionalCare took over, there were “approximately 800 employees.” Now, she said, there are 680. But if they can avoid a layoff, they will, said Dionne.

“We take our role as [one of Ottumwa’s] largest employers seriously.”

So when the possibility of layoffs loomed, he and his staff developed an early retirement plan. If 23 employees took advantage  of the program, ORHC could avoid most layoffs.

It worked out well, Dionne said: Around twice as many employees volunteered to accept the retirement package, which meant the hospital had job openings to fill for new employees.

Dionne recognized that some physicians have pulled up stakes, but those he spoke with talked about their spouse needing to find employment, not bad feelings toward ORHC or the community.

In fact, physician recruitment is probably one of two main missions for Dionne.

“Since RegionalCare [became owner], 16 physicians have been recruited. Unfortunately, 20 have migrated out,” he said.

But he and his staff will continue to bring in more doctors. The community could probably stand to have another 26 doctors. The wait to see a doctor — if you can even get in — can be distressing to residents, he said. And apparently, having connections doesn’t always help.  Dionne has been here for a year and has to go to Oskaloosa to see his doctor. That may begin to change for him and other residents.

There’s a new orthopedic surgeon who has been recruited to Ottumwa, an internal medicine doctor and, as has been suggested by several members of the public, a female doctor who will be joining an OB/GYN clinic.

“We’ve had a lot of support from the community in making that happen,” Dionne said. “There are not enough primary care physicians [nationally], so we need to stand out.”

Some of the changes could attract patients as well as physicians.

Both the emergency department and the ICU have been renovated and  two medical office buildings have been built. Management, seeing a shortage of mental health resources, is in talks to start a mental health inpatient unit for individuals 55 and over.

The new CT scanner and its special equipment use less radiation but provide a clearer picture. The physical rehab center is one of the best in the nation, Dionne said. The hospital is introducing a hospitalist program of in-hospital doctors so overworked doctors don’t have to take turns being on call at all hours of the night. ORHC is looking for an additional walk-in clinic, maybe on the north side.

That clinic would be separate from the hospital and not necessarily at the clinic next door, a large medical building that is not owned by the hospital.

The University of Iowa, which runs several statewide medical cancer treatment clinics, is going to step away from doing that. In this area, ORHC is ready to take over those duties.

Besides the challenge of recruiting in-demand doctors to “rural” Iowa, there’s the fight against the hospital’s own reputation. There have been citizen concerns raised about the hospital, and those worries continue to appear “true,” Dionne said, because those people have not seen the positive changes. He wants that to change.

Right now, the CEO said, that public perception problem will start to wear off after the public sees employees continuing to do a good job.

Part of that means big change, however, including reducing waits in the emergency department from two hours and fifteen minutes (which he said is actually below the national average) to under two hours.

Focusing on quality will show people they were right to choose ORHC and that they can feel comfortable doing so again, Dionne said, adding that such a model is good for business and the community.

And by treating employees better, said Dionne, the hospital gets better treatment for the patients. The hospital has worked to improve employee satisfaction through competitive salaries, fair job reviews, the new benefits package and a sense of ownership because employees are listened to.

Between work on the public’s perception of the hospital and recruiting doctors to reduce wait times, Wood said, “I think in another year, the community will see those won’t be a problem.”