Box Butte General Hospital welcomed its first patients 42 years ago, including expecting mothers. Since the first babies born there in 1976, doctors have delivered three generations. At a business before hours event Friday, members of the BBGH Executive Team confirmed a temporary suspension of labor and delivery effective the beginning of January 2019.
Hospital CEO Lori Mazanec, one of panel members, opened with background leading to the suspension. Through Dec. 31, Dr. Teri Myers, with Alliance Family Medicine (AFM), will continue to see all patients due. She has been the sole resident delivery and labor physician since Dr. Timothy Narjes, also at AFM, no longer offered the service as part of his practice. Mazanec emphasized Myers will continue in her Alliance practice — family medicine, obstetrics and gynecology (OBGYN).
In the interim, the emergency department will be available and prepared for deliveries. Mazanec explained BBGH is also working with its staff and Regional West Medical Center in Scottsbluff for emergency services. Patients who chose Alliance for OB care will be treated in collaboration with RWMC (which offers services such as telemedicine) and surrounding hospitals to complement their care.
Suspension of services is temporary as BBGH is actively recruiting one or more physicians interested in offering labor and delivery services here in Alliance. The hospital has contracted with an outside firm to find qualified Family Practice/Obstetric providers. Mazanec said the community will receive updates as “we advance our mission to lead and innovate in healthcare delivery and community wellness.”
Eighty-five babies were born at BBGH (one in the emergency room) over the past fiscal year. Five years ago, when the hospital had more providers in labor and delivery, the Kids Count in Nebraska Report included data for total births by county in 2008 and 2012. In Box Butte County a decade ago the total was 165 and 158 in 2012. Deliveries at BBGH peaked in direct correlation to the Burlington Northern Railroad’s Alliance expansion. Panel member Mary Mockerman, chief quality officer, estimated a high of more than 200 annual births between 1978-86.
A timeline to offer to pregnant women with in BBGH’s service area will depend on the recruiting process. The same company tasked with the legwork in this case secured two OB doctors for the Sidney hospital recently. The search for Alliance is nationwide with an emphasis on the Midwest Region. Individuals who showed interest in Sidney could be tapped as well to consider a comparable opportunity. Mazanec mentioned a third-year resident at BBGH this year who she hopes will decide to return in that capacity, though he would not be available until summer.
Within the field finding somebody like Myers is challenging. In the U.S. “only 1 percent of doctors out of residency specialize in OB, “Mazanec said. The recruitment process is ongoing for any vacant or potential position at BBGH, not just when for “stork deliveries temporarily re-routed,” as noted on an informational card Friday. In the case of Narjes and Myers, Narjes began as an employee of the hospital before moving to private practice at AFM, and Myers spent a rotation at BBGH in her path to the same clinic. “Both are very committed to the community,” Mazanec said.
Only rare stork sightings has been a contingency for pregnant when looking for care locally prior to an official announcement. How many choose BBGH for delivery in the future will be affected by the length of the suspension. Mazanec mentioned possible leads, some declining with considerations ranging from weather to distance from family. “We have to talk about what can we do as an organization to continue seeing those patients what can we do on the front end to promote our services and then try to reach back out to them after they’ve delivered … I definitely think there’s some long term effect but I think it’s all in how we promote our services once we do get them back up and running and why they should come back to Box Butte General,” she said.
Women also choose non-traditional options for childbirth, such as a doula or midwife. The panel said they have had that discussion, noting each state has its own laws — in Nebraska “babies have to be delivered by a doctor,” Mockerman said. A physician’s assistant (PA), considering another example, has to be connected to a doctor and cannot perform a C-section.
The hospital is working to increase the presence OB providers at its multispecialty clinic. BBGH is among facilities classified as Critical Access Hospitals. Mazanec said their status is common for these hospitals with “more and more quitting their labor and delivery programs.” OB staff here will not see a reduction in force, she said, with former time dedicated to that department spent elsewhere.
The panel assured those present that updates would be conveyed through the local media when available.