"We are not like other businesses, like an ice cream shop, that can lay off employees and then rehire them. These are people who sought out an education and are certified, so you can't do that. It's very difficult to go through the seasons where our patient population drops off and productivity suffers… We are lean, but at some points during the year, there is not a lot of patient volume to support the need for staff," she says.
C. A. Dean Hospital, circa 1920r
Clark says that because SVH isn't as remote as some rural hospitals, it has the advantage of being able to consider a job sharing situation for specialists that the system needs but not on a full-time basis.
"Sometimes we don't need a specialist full time, and we'll try working with one of our sister hospitals within Eastern Maine Healthcare System to try to think outside of the box by having the physician work two days a week in one hospital and three days a week at another," he says. "These are specialist that are needed in our communities, and we think joint recruitment can benefit both hospitals."
Typically in this arrangement, the specialist is employed by one of the hospitals, which is then reimbursed by the other for the hours the physician spends providing care to its patients, Clark notes.
Making Do, Building Alliances
Low operating margins can make it difficult for a rural hospital to keep pace with needed building upgrades—something C. A. Dean struggles with regularly, according to Goodrich. The hospital's roots are tied to a logging operation that became a large paper company and expansion over the past 100 years has been modest. A second hospital building was erected in the 1960s, and hospital leaders have worked hard over the years to forge regional affiliations.