By Robert T. Braithwaite and Gary McKitterick
11:21 AM PDT, May 24, 2013
The recently completed affiliation between Hoag Hospital and St. Joseph Health (SJH) was the result of a thoughtful process by both organizations and their boards of directors.
Our combined purpose was to create a collaborative network of care — known as Covenant Health Network — to enhance service capabilities to our Orange County community as we look ahead to the vast array of health care needs that will be required. Certainly, there were, and are, complexities in maintaining respect for the heritage of two faith-based organizations, one Catholic, one Presbyterian.
Women's health is an extremely important issue to the Hoag Board of Directors and administration. We took a proactive approach to the preservation and continuation of health services for women. In fact, the affiliation agreement recognizes the creation of a new governance structure for the Women's Health Institute that operates separately from the governance of Covenant Health Network.
It may, therefore, seem incongruous to some that Hoag recently announced our decision to discontinue elective abortions at Hoag.
So why would Hoag, after working diligently to preserve health services for women, discontinue elective abortions?
And why now?
As one might expect with such a highly-charged issue, some people in the community have expressed concern. Unfortunately, some important facts are being clouded by misinformation, and we believe it is important to clarify how the decision was made.
As we pursued the affiliation, we recognized the sensitivity of this issue and others, and undertook a comprehensive, clinically led, evaluation of our women's health services. Although consideration of the affiliation prompted the timing of our assessment, it should be made clear that St. Joseph Health did not pressure Hoag to take any specific action.
Our analysis revealed that approximately 100 elective abortions have been performed at Hoag facilities by fewer than 10 physicians in each of the past two years. The requirement for clinical excellence goes beyond the medical procedure itself and requires a full complement of services.
These include a comprehensive range of education and support, such as pre-and post-procedure support services, counseling and a full array of reproductive family planning services. We believe collaborating with organizations that offer more comprehensive and integrated services, such as Planned Parenthood, UC Irvine's Women's Options program and other providers, best serve women in our community.
These programs are led and staffed by physicians, many of whom are fellowship-trained in family planning services. Many Hoag physicians have referred their patients to these programs consistently over many years. In fact, several local providers have assured Hoag that they have the capacity and offer the expertise and optimal environment for women needing the service.
A few other facts: Statewide data show that less than 5% of elective abortions are performed in hospitals. At Hoag, 95% of the patients who had elective abortions were privately insured, 3% were covered by the Medi-Cal program and only 2% were eligible for and received charity care.
It is important to note that this clinical service change on elective abortions does not impact any other current women's service. In approving the affiliation, the attorney general said Hoag must continue to provide all other women's health services for at least 10 years, and the Hoag board will maintain decision making authority of clinical services. Those services include permanent sterilization, contraception, management of pregnancy complications and complications related to pregnancy termination at other facilities.
What will never change at Hoag is our unyielding commitment to provide our communities with the finest and most advanced health care possible. When the decision was made to eliminate in-patient pediatric care in 2008 and work with Children's Hospital of Orange County, there was a similar concern expressed in our community. Five years later, that clinically-determined decision has resulted in our community being better served, and we are confident that the same holds true with this decision.
The leadership of Hoag's Women's Health Institute and the Hoag Board of Directors is committed to providing patients seeking an elective abortion, an accessible path to comprehensive, high-quality resources in our community that will best support their needs.
ROBERT T. BRAITHWAITE is president and chief executive officer, Hoag Memorial Presbyterian. GARY MCKITTERICK, is chairman of the Hoag Board of Directors.