LRGH president: Outpatient problems addressed after confusion

LACONIA — After a confusing start, LRGHealthcare’s effort to offer outpatient services despite a big staff furlough has provided care to hundreds of people, President and CEO Kevin Donovan said Friday.

He acknowledged the furlough of 600 people, announced on April 3, came without sufficient planning or communication about how patients could receive ongoing care from a staff cut nearly in half to provide surge capacity for the coronavirus pandemic.

Some people reported they couldn’t get calls returned, didn’t know how to refill prescriptions or now have to travel a longer distance to get treatments, including for cancer.

“New systems have been in place for about a week now and things are running more smoothly,” Donovan said.

The hospital’s emergency department and critical care facilities remain open, but other hospital departments were closed and many doctors were among those furloughed. Donovan did not provide a breakdown by job description for those who are off the job.

A system has now been set up under which patients can call their doctor, even if he or she has been furloughed, and get information allowing a prescription to be refilled, help over the phone or computer, or an in-person appointment.

“In the last week, we have seen over 250 patients in one of our remaining offices and over 400 patients have had a telehealth visit,” he said. “We have answered over 4,000 phone calls and our nurses have triaged over 1,200 patients by phone.

“We expect these numbers to grow substantially and have actually added some more staff to meet demand.”

Each closed doctor’s office has a phone message directing patients to a patient portal to contact their provider or a phone number, if they prefer to call. For prescription refills, patients are asked to contact their pharmacies and have an electronic refill request sent.

Donovan addressed concerns from people needing ongoing treatment.

“We know that many patients, such as those receiving cancer treatments, now have to travel to Concord or other locations,” he said. “Undoubtedly, this is not what they want or need at this point in their lives and our hope is that we can bring such services back as soon as possible.”

The U.S. Centers for Disease Control and Prevention has urged hospitals to emphasize telehealth options to reduce chances for disease transmission. 

Many hospitals are feeling a financial strain associated with the coronavirus.

Catholic Medical Center has idled 700 workers. Elliot Hospital and Southern New Hampshire Health announced it would furlough 650 people and cut the pay or hours of another 750.

Even with the furlough of 600 people, LRGH still has about 700 to 800 employees who are on the job.

LRGH, which already had major financial problems, lost 60 percent of its revenue when it ended elective procedures in anticipation of a COVID-19 surge.

This posed an existential threat to the health care system, which operates Lakes Region General Hospital and Franklin Regional Hospital. Even with subsequent financial assistance from the state and federal government, it’s not clear whether the 120-day furlough can be reduced.

Donovan said LRGH has 45 outpatient-based physicians and advanced practice providers who are seeing patients either through telehealth or in person, if required.

“We have coverage every day for general surgery, pulmonology, gynecology, orthopedics, urology, pediatrics, the Recovery Clinic, family practice and internal medicine,” he said. “Patients can request an appointment via the patient portal or by calling the office.”

He said many people are avoiding seeing a doctor for fear they will catch the virus.

“One area where we’ve seen this in the emergency room despite both our emergency rooms being open and accepting of all patients,” Donovan said. “Initially, non-COVID-19 emergency room visits were down by 65% or more, but we’ve begun to see those emergency room visits increase again.

“Clearly, there were non-COVID-19 patients avoiding the emergency room for fear of being exposed. We have excellent systems in place to protect the health of patients and health care workers and people should seek emergency care, if they need it.”

Steps are being taken to provide essential services while minimizing the chance for spreading the disease.

“For example, we are seeing well babies and newborns in a designated well section at Westside Healthcare in Franklin,” Donovan said. “We are also scheduling patients for immunizations and injectable medications as needed. For patients who cancelled appointments, we have a log and are calling to reschedule once we are back up and running.”

He said some doctors are donating their time. Also, the senior management team has taken a 20 percent pay reduction. Management in total has been furloughed at the same percentage as the rest of the organization.

“We are extremely grateful to the members of our medical staff and the entire workforce who have stepped up to serve the patient population in need,” Donovan said. “People want to make sure they are compensated appropriately for work they do, but they are motivated not by money but to serve the community.”

People who do not have access to their regular doctors have been harshly critical of LRGH, while others understand that the scaling back services is not something Donovan wanted to do and that it’s something that is now happening in many parts of the country.

“I’ve been heartened by those who have supported us,” he said. “I have felt saddened by those who are critical, but not because I blame them for being critical.”

Donovan said he understands how people can question reductions in needed and necessary medical care during a pandemic.

“I fully support that question. I am hopeful people will give us a chance to prove again why we're a good local health system to meet their needs.”