Catholic hospitals face myths,
mergers
By PATRICIA
LEFEVERE Special to the National Catholic
Reporter Newark, N.J.
Their names alone imparted a good portion of their identity:
Sisters of Mercy, Daughters of Charity, Bon Secours -- sisters and dispensers
of health and hospital care in the United States for more than a century. But
today the hospital and health care institutions founded by these women and
other religious like them stand threatened.
The threat comes not only from a marketplace that competes
fiercely for patients, staff and reimbursements, but also from the fact that in
a restructured health care environment, Catholic identity risks taking a back
seat to bottom-line considerations.
Late last month some 60 lawyers, bishops, priests, nuns and
hospital and diocesan administrators gathered at Seton Hall Universitys
Law School here to share their concerns and see how they can survive in an era
of joint ventures, mergers and acquisitions.
St. Joseph Sr. Jean de Blois told them not to wait until they are
in negotiations with a potential partner to think about who they are as
Catholic health care providers. Instead they should begin their discussion of
self-identity now, urged de Blois, who is vice president of mission services
for the St. Louis-based Catholic Health Association of the United States.
She also cautioned them not to assume that their colleagues on the
negotiating team would be intimately well versed in knowing the data of
who you are and not just what you wont do. Everybody knows and has
known for years what Catholic hospitals dont do, de Blois said, naming
the proscriptions against abortion, doctor-assisted suicide, tubal ligation,
sterilization, in vitro fertilization and other reproductive interventions.
However, too few know what an institutions hopes and dreams
are; what its policies are for hiring, firing and managing employees; and how
it performs clinical care. The major challenge for many working in the field is
that we dont know what it means to be Catholic in health
care, de Blois said. But when you take Catholic gospel principles
and speak them in English, theyre very appealing, she said.
Theyre not just Catholic values, theyre human
values.
These values include having a mutual understanding of the
vulnerable and basing employee relations on trust rather than manipulation, she
said.
They also encompass effective pain management and believing in the
pastoral and spiritual welfare of patients as well as in their physical and
psychological care.
The successful negotiator will see Catholic ethical statutes and
religious directives in a positive light and will seek to expand upon them in
the negotiations, de Blois said. Too often Catholic negotiators
saddle themselves with a narrow view of Catholic identity rather
than asserting what were about, what we expect and what were
looking for in a health care partner.
Despite being the largest private not-for-profit system in the
United States -- counting some 550 hospitals in 48 states, which employ 679,000
staff members and treat more than 74 million patients yearly -- Catholic health
care is still seen in a negative or fearful light by many, she said. De Blois
said that in recent restructuring talks in a number of states, several
myths about who people think we are surfaced:
- Money goes to the Vatican from earnings in the Catholic
facility.
- Daily Mass is required of all employees.
- All meetings must begin with prayer.
- The prohibition against doctor-assisted suicide means that a
Catholic hospital will let no patient die.
- Women are allowed to die in childbirth in order to save the
baby.
- The local bishops authority over the hospital means that
he will run health care and will be involved in decision-making sessions
between doctor and patient.
De Blois said Catholics need to ferret out these myths
if they are to succeed in their new arrangements.
De Blois told NCR she was hopeful that the ministry of
Catholic health care would survive merger mania, funding cuts and
even the growing obsolescence of hospitals now that three quarters of all
surgery is done as outpatient procedures and home health services for Medicare
patients have contributed to a significant drop in hospital admissions.
How Catholic health care providers continue to deliver integrated
quality services across the continuum of life to the communities they seek to
serve remains the churchs greatest health care challenge, she said,
adding that lay leaders will carry us into the future.
Finding appropriate members for hospital boards must remain a top
concern of Catholic institutions, advised Oblate Fr. Francis Morrisey of St.
Paul University in Ottawa. He warned that within a decade, the church could
lose its hospitals, clinics and rest homes -- not from competitive forces
outside, but from within.
Lots of our board members are put there because theyre
successful in business or pious, but they have no idea about Catholic ethics
and have a great gap in their Catholic knowledge, he said. Yet they are
the ones making the delicate decisions, he said.
Morrissey, a canon lawyer, said that programs need to be initiated
for prospective board members so that their leadership role within the church
can be clearly identified and supported.
Morrissey also noted that canon law isnt the doctrinal
arm of the church but rather its practical law. How it is interpreted may
vary in different states and sees, and church law must remain flexible if it is
to serve 1 billion Catholics worldwide, he said. Morrissey said he knows of
only four nations whose bishops have issued ethical criteria for health care
procedures but said that the local bishop is the interpreter of such criteria
in every diocese.
Bishop James McHugh of Camden, N.J., said that neglecting to
involve the bishop in restructuring negotiations is a recipe for failure. By
virtue of the bishops role as governor of the diocese, as teacher and as
a prophetic voice in the community, he needs to be kept abreast of negotiations
and his counsel needs to be heeded, McHugh said.
McHugh interpreted the rush of mergers, affiliations and buying
and selling of institutions to a nervousness on the parts of CEOs
and boards. In the aftermath of such courtships and arranged
marriages, he held that it is vital that Catholic health care continues
to live by Catholic moral principles and continues its mission to the poor and
to migrants.
Fr. Dennis Brodeur of SSM Healthcare in St. Louis said that most
of the ethical issues in hospital management are part of the practical
management of the institution. Questions of management style, rates of
compensation from top executive to janitor, the transfer or loss of pension
funds, conflicts of interest, the resolution of grievances, patient care and
how the institution pursues social justice in the community are key components
of the negotiation and of how Catholic the new entity will be, he said.
Catholic social teaching informs all these questions, he said.
National Catholic Reporter, November 20,
1998
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