Gloucester Daily Times - October 17, 2003 Hospital trustees support changes By KARL MUENCH Staff writer BEVERLY -- The volunteer boards of trustees overseeing Addison Gilbert Hospital's parent company voted yesterday to declare change at the Gloucester hospital inevitable. And without it, they said, they will close the place. The boards for Northeast Health System and Northeast Hospital Corporation met in the morning at Beverly Hospital and voted unanimously to support changes that have been mentioned in the past by hospital management as the means of ensuring local health care survives. "The primary mission of NHS has not changed -- we are committed to maintaining a health care presence on Cape Ann," reads a statement issued by the boards yesterday. "This can only be accomplished, however, if these essential steps are implemented." The boards said by "health care presence," they mean maintaining "a level of in-patient care and emergency department services at AGH, for the residents of Cape Ann." Addison Gilbert operated as an independent community hospital from 1897 -- when it took in its first patient, a fishermen hit by a train as he walked home to Manchester -- to 1994, when hospital trustees bowed to health care trends and intense competition. The merger with the larger Beverly Hospital that year created Northeast Health System. But the same trends that forced the merger still bear on the hospital. This year, concerns over Addison Gilbert's future spiked on Cape Ann, as Northeast management neared the end of a three-year review determining a long-term plan for the entire health system. Northeast President and Chief Executive Officer Stephen Laverty and his team started meeting last spring in private sessions with community leaders, explaining what they said are the realities of the health care industry. Some of those discussions have since become public, particularly before a task force formed by state Sen. Bruce Tarr aiming to save Addison Gilbert, but details about the hospital's future have been few. Hospital leaders' key point has been their need to foster more use of services in Beverly by Cape Ann residents -- in other words, to move some services from Gloucester to 15 miles down Route 128 and hope local patients will follow. Also last spring, local doctors bought a full-page advertisement in the North Shore's newspapers, blasting the Northeast management and begging for a meeting with trustees -- without Laverty. Those doctors have been keen to point out that once patients get on the highway, they could just as well bypass the exit for Beverly and keep going to Salem or Boston. The doctors at Cape Ann Medical Center are affiliated with a competing system, Partners HealthCare, which centers on Massachusetts General Hospital and includes Beverly Hospital's nemesis, North Shore Medical Center in Salem. But those doctors are also responsible for the great majority of admissions at Addison Gilbert. And they could be the source of other revenue for the hospital, if Northeast managers had their wish and the doctors shifted their offices from the Blackburn Industrial Park to vacant space at Addison Gilbert and started using more laboratory and radiology services there. The trustees eventually granted local doctors an audience. But the statement issued yesterday indicates no daylight showing between the trustees and Laverty's management team. The trustees' statement follows precisely -- even in the lack of details -- what hospital management has so far let out publically. "We have confidence in our team of executives and physician leaders and encourage others to support them as they take on this important work," the statement reads. The trustees instructed Laverty and his team on four actions for Addison Gilbert: Restructure in-patient services. Relocate other health services available on Cape Ann to the hospital property. Consider the elimination of off-hours and weekend surgery. And engage a real estate broker to rent out or dispose of whatever part of the property remains vacant. "Without the timely implementation of these changes, which are vital," reads the statement, "... closure will have to be pursued by the trustees." Local doctors have said they are willing to move offices to the hospital building, but have called keeping off-hours surgery "non-negotiable," seeing it as the key to maintaining a life-saving emergency department. Northeast managers have said the seldom-used service costs $500,000 per year just to keep anesthesiologists on call, with a medical need yet to be determined. The statement from the trustees said they recognize local anxieties about the hospital and will provide regular updates "during the initial transition phase." "We appreciate the time many members of the community have dedicated to expressing their concerns and ideas," the trustees wrote to a Cape Ann community that has deluged this newspaper's editorial page with opinions on the subject. "However, this is a decision that resides with the trustees who have directed management, including the medical staff, to solve."