Health center pledges to stay; mayor ‘concerned’

March 1, 2013
By

JACKSON SQ.—Boston Children’s Hospital (BCH) has committed to providing children and adolescent services at the Martha Eliot Health Center (MEHC) for the foreseeable future, but a “thoughtful” process will take place to determine the exact structure of that care.

“We have a commitment for pediatric care for this neighborhood,” said Dr. Shari Nethersole, MEHC’s acting medical director, in an interview at the Gazette office.

MEHC, which is located at 75 Bickford St. in Jackson Square, recently announced plans to end service for about 5,000 adult patients by July. Adult service was provided in partnership with Brigham and Women’s Hospital (BWH), which revealed to the Gazette that it was not consulted about the decision.

“We were as surprised as anyone else. It was communicated not as a request for a conversation, but as a decision,” Dr. Joseph Frolkis, BWH’s director of primary care, said in a conference call with Sharon Vitti, BWH’s vice president of ambulatory services and women’s health, and the Gazette.

Vitti added that the results might have been different if BCH had entered into discussions with BWH.

Mayor Thomas Menino is “concerned” about the MEHC changes, according to a Feb. 14 letter he sent to BCH.

“I respectfully request that you partner with my team at the Boston Public Health Commission (BPHC) to ensure that this transition is as smooth as possible for your existing patients, health center employees and the community at large,” Menino wrote.

“We have been in communication with him and the Boston Public Health Commission as we begin to carefully help the adult patients at Martha Eliot Health Center to find new local adult providers to meet their health needs moving forward,” said BCH spokesperson Rob Graham.

Ben Day, who chairs the Jamaica Plain Neighborhood Council and works in health care policy, is among the local leaders questioning the move.

“[Community health centers] provide the same care for much less money than hospitals—which is where more people end up going when we shut down health centers—and they are often the only providers dedicated to serving communities of color and low-income communities who face higher health risks,” Day said in an email to the Gazette.

Nethersole reiterated that the decision to cease adult services at MEHC was not a financial one. She said the driving factor behind the decision was the fact that BCH is a hospital that provides services for children, not adults, and that the health care industry is changing.

She noted that the health care industry is beginning to network adult primary care providers and specialists to fine-tune care for chronic conditions, such as heart disease. Nethersole said BCH made the decision to focus on what it does best: treating children and adolescents.

Asked why the MEHC community advisory board or other community groups were not consulted about the decision, Nethersole said that the decision involved internal administration, not community programming. The advisory board is not the same as a board of trustees overseeing a nonprofit, she noted.

Mildred Hailey, who sits on the advisory board, spoke to the Gazette on the morning of Feb. 25 and said people want answers about why the services are ending. She said a board meeting with MEHC officials was expected to take place that evening.

MEHC treats only about 300 adult patients and about 300 children patients from the adjacent Bromley-Heath housing development, as the Gazette previously reported.

Nethersole said that the low numbers can be attributed to the “demographic changes” at Bromley-Heath, as well as across the city, where people who already have doctors elsewhere move in. But, she acknowledged, BCH has not conducted any recent studies of patient needs and habits in the area.

BCH was providing adult care at MEHC in partnership with BWH, which provides nurse midwives for obstetrical care. BWH also partnered with BCH to provide a teaching program where doctors-in-residence would treat families. Nethersole said BWH also provided support for the adult electronic records, but BWH spokespeople were unsure of that.

Nethersole said BCH floated the idea of ending adult service to BWH last spring, but nothing came of it. Nethersole was not involved with those talks because she said they happened at the “senior level.” BCH did not consult with BWH before telling it in January that adult services were ending.

Vitti said that during the discussions last spring, the options that were floated would not have allowed BWH to continue focusing on its two current centers—the Brookside Community Health Center and Southern Jamaica Plain Health Center. She said that BCH had asked BWH if those two centers could absorb all of MEHC adult patients.

Now that the decision has been made, BWH said it will continue to work with BCH to help the MEHC adult patients wherever it has capacity to do so.

Nethersole said BCH will hold information sessions for adult patients on March 20 and 23 at MEHC. She said that BCH has encouraged MEHC adult patients to talk to their primary care providers about the best options for them. BCH hopes to have the transition done by July, but will provide services until new doctors are found.

Nethersole said about 11 health centers across the city, including the Dimock Community Health Center in Jackson Square and the Whittier Street Health Center in Roxbury, have been determined to have capacity to take adult patients.

The future structure of MEHC will undergo a review over the next couple of months, according to Nethersole. Included in that review is the community program, whose director was laid off last September, Nethersole said. The community program consists of such programs as the Jamaica Plain Violence Intervention and Prevention Collaborative and the Youth Leadership Program.

MEHC may be contacted at 617-971-2100.

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