NEW YORK — Daniel Sulmasy, OFM, M.D., who holds the Sister of Charity Chair of Ethics at St. Vincent’s Hospital in Manhattan and is professor of medicine and director of the Bioethics Institute of New York Medical College, wrote about the shrinking U.S. Catholic healthcare system in the March 16 edition of America: The National Catholic Weekly.
In a bylined cover story titled, “Then There Was One: The Unraveling of Catholic Health Care,” Daniel discussed how eight Catholic acute-care hospitals in New York City have merged down to one in the past two years in a morass of financial ruin, mismanagement, and problems. The following synopsis is taken from America.
How Problems Began
Daniel, a medical doctor, wrote that the problem began when Cardinal John O’Connor of the Archdiocese of New York put all Catholic hospitals and nursing homes in a newly-created Catholic Health Care Network, with initial plans for a merger. But there were many problems with the merger, including concerns about finances, governance, and a basic unwillingness to join together, according to Daniel.
First, St. Vincent’s Hospital, which gained national fame for its proximity to Ground Zero and aiding victims after the Sept. 11 attacks, was experiencing financial problems. Owned by the Archdiocese of New York, St. Vincent’s was supposed to merge with St. Vincent’s Staten Island, which was owned by the Sisters of Charity, and hospitals in the Diocese of Brooklyn. The three-way merger was thought to give an unfair 2-to-1 advantage to the archdiocese, so Cardinal O’Connor turned back ownership of St. Vincent’s Manhattan to the Sisters of Charity. The merger proceeded.
After the merger in 2000, a new board ran the merged group, called St. Vincent Catholic Medical Centers of New York. From the start, there were challenges, Daniel wrote, including resentment and management problems with doctors refusing to refer patients to others hospitals. Red tape and a morass of paperwork crippled the system.
After Sept. 11, he wrote, a declining number of New York City residents in downtown Manhattan left beds empty and huge financial losses at St. Vincent’s. It often came close to being unable to meet payroll, pay vendors and creditors, and order supplies. The CEO was fired and the hospital declared bankruptcy. At the same time, other beleaguered hospitals closed, were shut down or were sold, as the archdiocese tried to extricate itself from the hospital business.
As of today, only the struggling St. Vincent’s remains.
What Went Wrong
Daniel discussed why mergers often fail, mostly because of inattention to cultural differences between organizations. He described several lessons that have emerged, and he closed with a defense for the Catholic hospital.
He wrote, “Some might wonder why one should bother to save Catholic institutions. Perhaps the time has come to abandon bricks-and-mortar Catholicism and instead to live the faith by blending like yeast into the secular society. Personally, despite all the obstacles, I continue to be convinced that Catholic institutions (and, in particular, Catholic hospitals) are worth fighting to save. Catholic institutions help to nourish the faith of those who work in them and are served by them.”
“Our Catholic hospitals also provide a vehicle for proving that our moral convictions are compatible with 21st-century technology, and they embody the ideal that service institutions ought to have service missions. In health care, patients and practitioners alike are becoming alienated from the health care delivery system. Hospitals that treat patients with true respect, recognize their dignity, attend to their spiritual needs, value people over technology and value service over the bottom line are precisely the remedy that people need. Given their mission, Catholic institutions should be leading the way.”
Daniel is author of The Rebirth of the Clinic. As of July 1, he will serve as the Clinton-Kilbride professor of medicine and medical ethics at the University of Chicago Medical School and as professor of medical ethics at the University of Chicago Divinity School.