Dear Readers,

Once upon a time a customer asked Tim Hodgdon to build him a super sailing yacht. “Oh yes,” added the customer, “I would like you to build a pipe organ in the master salon.”

Hodgdon, East Boothbay’s master yacht builder, had just one answer that went something like this: “Sir, do you want your organ on the port side or the starboard side?”

Now, Hodgdon is not just a great yacht builder. He also knows how to run a shipyard, and that quality is what sets him apart from many other fine boat builders. Tim Hodgdon knows that pleasing his customers is a big part of running a successful shipyard.

As it is in yacht building, and in other kinds of businesses, it is just common sense to please your customer.

In recent weeks, it is no secret that folks on the Boothbay peninsula (a.k.a., the customers) are hopping mad at the decision (by the business owners) to shut down St. Andrews Hospital and replace it with something called an urgent care center.

The owners and managers in this case, Lincoln County Health administrators and staff, are trying to peddle a product their customers just don’t want. And their customers have not been reluctant to express their outrage.

To add insult to injury, a month or so after they stunned the community when they announced their decision, the Lincoln County Healthcare brass have not budged one inch from their original position, despite requests for delay from town officials.

Instead, the Lincoln County Healthcare bosses move forward telling us at every opportunity that they made the right decision and we should get over our anger, use a bit of common sense and accept the decision by the “experts.”

When the customers balked, Lincoln County Healthcare tried to tell us money is not driving their decision. Then, oops, they backed down and admitted it is just too expensive to deliver services at St. Andrews.

Then they tried another story. They tell us it is a quality of care issue. They explain the skills of their docs and nurses and aides will get rusty if they only have a few customers each day.

Lincoln County Healthcare's big boss, Jim Donovan, who has been strangely silent since the announcement, has sent his surrogates out to convince the public that they will be served “almost” as well with something called an urgent care center.

One of Donovan’s surrogates, Dr. Mark Fourre, a quiet and sincere man, recently sat down with me to explain why Lincoln County Healthcare is doing the right thing.

There is just not much business in the St. Andrews Hospital emergency room, he said. As a top pro emergency room physician, he said he would love to sit down for a couple of days in a quiet emergency room. It would give him a chance to catch up on his medical journal articles. But after a day or so he would be bored to tears.

You see, he explained that he used too work in a big city emergency room that was packed with business, like the storied Saturday Night “knife and gun clubs” that brought dozens of bleeding emergency room customers bearing wounds that a combat medic might see in Baghdad. Lots of work keeps emergency room trauma teams on their toes, he said.

Then he explained how lucky he was to settle his family in our area, not far from the shores of a lovely neighboring lake. It is a delightful area and the fishing is good too, he explained. Then he returned to his theme that Boothbay just doesn’t have enough business to support a little hospital.

Moving the Boothbay patients to Damariscotta is not a bad move, he said. And our ambulance emergency techs do a great job and patients will get great care at Miles Memorial Hospital.

Folding St. Andrews Hospital and its patients into Miles should stabilize the local healthcare situation – for about 5 years, he said. After that, I asked, will Miles be in trouble? He couldn’t say. There are no guarantees they will survive either. After all, they are almost as small as St. Andrews.

Well, Doc, what did you expect when you moved here? You came to a beautiful spot, and love living in a community where lots of folks don’t lock their doors and frequently leave the keys in their cars. You came here for a quiet life for your wife and kids. We live in a lovely, quiet place, at least it's quiet for most of the year. Despite the age of our population, I guess we are pretty healthy, too.

Do you think this might be one reason we don’t provide much business for the St. Andrews Emergency Room. Do we need an epidemic to rate emergency room facilities?

So, is living in a quiet community a good reason to shutter the ER? The fire departments and local police don’t have a lot of business either. Should we padlock their doors?

Goodall Hospital in Sanford is set to join MaineHealth. Parkview Adventist Medical Center in Brunswick is being courted by Mid Coast Hospital and the Central Maine Healthcare Network in Lewiston. In Blue Hill, they are buying out staffer’s jobs to slash costs and avoid layoffs. In Waterville’s Inland Hospital they are laying off some workers, too.

In our pages, neighboring hospitals have begun running ad campaigns seeking to lure healthcare business away from Lincoln County Healthcare.

I suppose conventional wisdom in health care management says when you have only a few customers in a group, you should close up the weak partner and merge it with the big brother. But a look around the nation shows that this isn't a perfect solution either.

Maybe Lincoln County Healthcare's administration ought take a page out of Tim Hodgdon’s book and try to please their customers. Maybe instead of slamming the door on their loyal customers, the big bosses at Lincoln County Heathcare might put their high-handed decision to shutter our little hospital on hold for a while and work with, not against, their old customers.

Maybe we all can work together to find a few new customers, or find a specialty practice, or some other kind of healthcare niche practice, which would bring new paying customers in St. Andrews’ front door.

And maybe, just maybe, Lincoln County Healthcare might generate enough money from the new customers to allow them to take care of their faithful old customers.