The Advantages of Promoting a Community Culture of “Carism”
BY ALAN IFTINIUK, PRESIDENT & CEO, FRENCH HOSPITAL MEDICAL CENTER
There is a troublesome fear I hear from some patients and members of our community, promoted by out-of-area medical centers that small-town health care is somehow — less than “Big City” care. Yet studies show nothing could be farther from the truth. In my article “How One Small Town is Reframing the Health Care Conversation,” I discuss how my institution, French Hospital Medical Center (FHMC), has created a unique “culture of carism” that puts patients first in everything we do. This article will explore how carism results in superior care while staying close to home.
French Hospital Medical Center is located in San Luis Obispo (SLO), serving California’s Central Coast. The area has a long history of drawing happy residents here for its combination of outstanding education, healthy lifestyle, temperate climate and a wide offering of art and culture. These same qualities also attract many of the best caregivers from large metropolitan hospitals who want to improve their own quality of life. They often give up better wages to be here and are willing to trade career mobility for a much more favorable work/family lifestyle balance. For French Hospital, this “SLO life” has always produced a plethora of riches.
The French Factor
In terms of employed hospital staff, we have always been fortunate to hire the best of the best. We assess an applicant’s reasons for wanting to work for us and evaluate each candidate on how progressive, dedicated and capable they will be. We ensure that anyone we employ is 100% engaged in our mission to:
- Deliver compassionate, high-quality, affordable health care services;
- Serve and advocate for our sisters and brothers who are poor and disenfranchised; and
- Partner with others in the community to improve the quality of life.
These values are non-negotiable.
The resulting pool of truly exemplary staff is referred to around town as having “the French Factor.” It manifests itself as genuine caring for not only the patient but everyone who comes in contact with our team — from neighbors to visitors to the area, community resource leaders to shelter volunteers. The French Factor is how we extend our culture of carism past the hospital doors into relationships with all of our emergency services brethren — police, fire, county health, mental health, and the like.
This is of consequential importance and unique to our small town because it’s these personal relationships that best facilitate the right care through proactive collaboration — this is what makes carism not just a lofty promise, but actually work. It is our competitive edge against other larger facilities.
You don’t have to take my word for it. There are publicly reported measures that tell us what we do — works. Many independent sources have named French Hospital one of the Top 100 Community Hospitals in the nation. It is on the Leapfrog Honor Roll for hospital safety. It is recognized for its low-risk emergency c-sections. And more than once, we have been named a Top 50 Cardiac Hospital. These numerous quality awards attest to our sustained commitment to our mission and values. The pride I have for our work is hard-earned day-in and day-out, because we have attracted not only the best healthcare providers, but more importantly, we are able to retain a cadre of “all in” fully committed professionals who best exemplify what carism truly is.
Advantages Over the For-Profit Motive
Lately, we have seen this dedication tested. We are in the middle of a concerning trend where large, heavily branded and distantly located metropolitan health systems set up offices in areas like ours where they perceive they can make big profits from our population. They bring with them their big brand names that sometimes win over less-informed patients. Once these non-local health systems see those patients, they sometimes go so far as to self-refer within their own network. This referral is often outside our local area and back to their home base of operations, rather than to whichever of our local facilities is best suited to the patient’s best care. As a non-profit hospital, we have numerous advantages over this out-of-town, predatory profit motive.
Every dollar of profit our hospital generates is reinvested in our patients in one way or another. In fact, true to our mission, we provide more charitable care in a year than what we would pay in taxes alone if we were for-profit. We have an integral research relationship with our local university — California Polytechnic State University — one of the top technical schools in the country. Plus, we attract an incredibly robust and dedicated pool of volunteers, many who have been with us for decades. Their commitment to our patients amplifies our own steadfast commitment; they are proud to give back. In fact, many of our volunteers are retired French medical staff who’ve come to miss, on a daily basis, our unique culture of carism and heed the call to “pay it forward.”
We are known for reinvesting in high-value community programs and highly personalized services not commonly found in metropolitan areas. This is especially true when it comes to providing a complete continuum of care for our patients. Our Nurse Navigators assist those who are discharged with a host of services to reduce the number of readmissions other hospitals see — readmissions that could easily financially ruin a family. They help with getting prescriptions filled at the most convenient places and checking in on adherence. They ensure the patient isn’t paying for something unnecessary or restricted by insurance. They set up physical therapy and other follow-up care. In short, they help work through the difficulties a patient may encounter on their own and provide an added layer of trust, safety, and responsibility. Whenever possible and medically appropriate — THE BEST CARE IS ALWAYS CARE CLOSEST TO HOME.
Prepared for What’s Beyond
When the worst happens, our community knows that we are caring, but we are also prepared. In an emergency, timing is everything. So we have taken steps to look beyond today’s needs and equip ourselves for any eventuality. Our current Beyond Health campaign is raising the necessary funds for facilities, technologies, and procedures that will better mobilize our teams and make every second count. Our focus is to understand and then exceed our community’s unique needs and expectations; rather than a hard focus on profits alone. Advanced preparation means keeping patients local.
For instance, our campus expansion plan will allow for a new helipad. The cost of our helipad was but one of many factors considered in whether to build it. Eventually, the preponderance of other crucial factors critical to emergency care in our community led to the decision to include the helipad in our expansion. This addition to our campus will ultimately create numerous new transportation options either from a trauma scene, or a facility less equipped or qualified — directly to our facility. Or alternatively, when required, from our facility to a partner facility for a higher level of care. Additionally, our investment in new diagnostic capabilities will provide a quicker response to an ever-changing and more medically complex population of patients. But it’s not just emergency care that we’re building greater capability in.
In fact, our investments in new facilities and technologies have continued to attract the very best specialists from the most prestigious institutions. There is no difference in caregiver quality for most procedures between French Hospital and anywhere else. Many times we can do it better. Better equipment and a top-notch facility mean we can often attract the best caregivers. We encourage the best of the best to innovate, re-engineer and reimagine how care should be provided. In short, we expect our team members to go beyond what is expected from a small community hospital. We make our investment decisions based on what our best caregivers tell us they need to provide the best care — and then giving it to them. This is not the same bureaucracy or favoritism they might encounter elsewhere. Every decision, every time, is made in the best interest of our patients.
Oftentimes an investment in one technology will launch us into providing the very best of another. The successful launch of our stellar robotic surgery program, for example, spurred our investment in an entirely new service line when this program drew the attention of a nationally renowned gastroenterologist specializing in endoscopic ultra-sound (EUS) and he relocated his high-value practice to French Hospital. Why? Because we have earned a reputation of trust among our community of physicians and an unsurpassed reputation for quality care throughout our community. Our community expects French Hospital Medical Center to always do the right thing and to be there for any medical eventuality.
That’s why carism…leads the way in SLO.
So where is this going? In short, our work and carism are still evolving. As times change, we will always search out where health care is heading and what is needed so that we can invest the intellectual resources, compassion, and funds needed to provide the very best care for our small town. We will continue to look Beyond Health to ensure that patients aren’t frightened, confused or fooled by an opportunist’s disinformation, and can trust that we are and will always be there for them not merely as patients, but rather as family, friends, and neighbors in our community. At French Hospital we go beyond straight-out clinical care, to encompass the whole person — body, mind, and spirit.
To be sure, there are no health care sacrifices our patients make to live in this special place — now or ever. Our mission and strongly held values dictate that our hospital’s culture of carism will remain in place for generations to come.
Keep up with the stories, insights, and progress of French Hospital Medical Center’s Beyond Health Movement at https://gobeyondhealth.org.