“This is one of the principal precepts of ethics taught in medical school and is a fundamental principle for emergency medical services. It reminds the physician and other healthcare providers that they must consider the possible harm that any intervention might do. It is invoked when debating an action that carries an obvious risk of harm but a less certain chance of benefit…”  Wikipedia

Dear Readers,

The medical care experts at Lincoln County Healthcare have decided to close St. Andrew’s Hospital. After a long series of service reductions that began when St. Andrews merged with Miles Memorial Hospital, the final action will be the closure of the emergency room and that means the brick building on the shore of Mill Cove will become something other than a hospital.

The experts at LCH have already decided that St. Andrews Hospital is no longer needed. It has become an expensive appendage, a drain on their finances.

You have to understand, they will argue, we feel your pain but it is all about the numbers. Trust us.

First, do no harm…

Don’t you understand, the LCH experts will argue, we have this facility just up the river that can provide the same – no, better – services than you have at St. Andrews.

All you will have to do is drive up the river to Damariscotta and we are there for you, they will argue. If the traffic is not too bad on Route 1, or the ice is not too slick on the River Road, it will take you only a few more minutes, a half hour – 45 minutes or so – an hour at most - to get there.

Unless you live at the end of Southport Island and if the bridge is open and that might take a few minutes more… If you are summering on Squirrel Island, well, that’s another story.

First, do no harm…

If you can’t get there on your own, they will argue, you can just call the Boothbay Region Ambulance service and they will bring you to our emergency room where we will take care of you. A few minutes more, a half hour or so, won’t make much of a difference in an emergency situation will it? And it won’t cost more, or not much more. Yes, the taxpayers will have to buy a couple of new ambulances and staff them with trained EMTs, but that is no big deal...

First, do no harm...

You must understand, LCH will say, it is not our fault. We have done our very best to navigate through the rocks and shoals of the confusing healthcare regulations. If you think it is difficult to read and understand a hospital bill, think of how tough it is to write one.

Besides, you have to understand, LCH will say, we have to deal with more than just patients. We are faced with Medicare, Medicaid, Blue Cross, the AMA, the Legislature, the governor, HIPPA, and Obamacare to list only a few. The state owes us a lot of money that we can’t seem to collect, and, of course, there are the trial lawyers. Yeah, they might argue, the trial lawyers are a problem. They are the real troublemakers.

LCH statistics show the St. Andrews E.R. has very little business anyway. Critics reply that for years LCH has shifted equipment and docs from Boothbay to Damariscotta. If the Irving gas station quit selling gasoline, just how much business do you think they would have? What came first, the chicken or the egg? 

First, do no harm...

Meanwhile there is a community on the end of a peninsula that has relied on St. Andrews for years. It is a region that understands a local hospital is a community keystone. It is one of the major reasons folks choose to live here. We are the oldest community in the oldest county in the oldest state in the nation. Grandmothers and grandfathers by the hundreds have chosen to live here, in part because of St. Andrews. We all have donated millions of dollars to support our hometown hospital.

Financiers and fishermen, grandees and grandmothers alike have given generously to help pay the region’s healthcare bills. Every year, the good ladies of the hospital auxiliary and their St. Andrews Thrift shop raise hundreds of thousands of dollars to purchase special hospital equipment health experts say is vital, but is just not in this year’s budget.

Realizing how important the hospital is to their community, the governments of the towns have exempted the hospital from paying property taxes and spent buckets of money to make sure they had utility services, like sewer and water. It was thought to be a sound community investment.

We know, we know, and we sure appreciate all you have done, LCH officials will argue, but we know best. Please understand, we are experts, professionals, they might say. We have thrashed this all out behind closed doors in our staff and board meetings. You must understand: LCH officials are the experts. They claim to know what they are doing. Trust us, they say.

Primum non nocere. First, do no harm…

Joe Gelarden