Island Community Raises Concerns Over Hospital; Board Listens in Silence


Members of the Martha's Vineyard Hospital board of trustees listened, for the most part in silence, to an outpouring of public concern and demands for change at a forum held Tuesday night.

Nearly 300 Vineyard residents, doctors and hospital officials gathered in the regional high school Performing Arts Center to discuss the current state of the hospital - spurred by the recent resignation of hospital surgeon Dr. Richard Koehler.

A parade of citizens stepped to the microphone to mourn the possible loss of Dr. Koehler - hailing both his medical expertise and his compassion. Some demanded that the hospital administration and trustees take steps to retain the surgeon, who has announced plans to leave in July along with his wife, Dr. Kathleen Koehler, a physician with a private Island practice in gastroenterology.

"If the Drs. Koehler leave, it will be a lose, lose, lose, lose situation," said Deborah Mayhew of West Tisbury, predicting that the hospital will lose revenues, the Koehlers will lose their home and community, the staff will lose essential members of the medical team and the public will lose excellent doctors.

"I'm a colleague of Richard's, and I'm also a patient. I've worked with lots of emergency room doctors, and this guy is tops," said Gerald Yukevich, a hospital emergency room doctor.

The Rev. Alden Besse suggested a skilled mediator meet with Dr. Koehler, the board and hospital chief executive officer Kevin Burchill. Forum moderator Patrick Gregory put the motion to a vote and it carried with only a few nays.

While many of the public's comments demanded immediate intervention to prevent the loss of the two doctors, some residents urged a broader view.

"There's continuous turnover of physicians. There's been turnover of some fine and some not-so-fine CEOs. The community is right to expect change. There's more here than a conflict between two individuals," said West Tisbury resident and Dukes County Health Council member Tad Crawford.

"Our hospital is an extraordinarily caring institution. It's not about the Koehlers, but rather about the kind of hospital we have," said Charles Silberstein, psychiatrist and chairman of the Foundation for Island Health. "The central question is can we maintain a sense of teamwork while freeing the hospital of financial debt?"

"What's happening between myself and Kevin Burchill is indicative of what's happening between the board and the public," said Dr. Richard Koehler.

"When you talk about mediation, this will not be a simple issue. There are deep philosophical issues. It involves a commitment [by the community] whether we stay or whether we go," said Dr. Kathleen Koehler, who is also a member of the hospital board of trustees.

A vote to plan a follow-up forum with key stakeholders passed unanimously. Another motion to recommend conflict resolution between the hospital board of trustees, hospital administration, staff, doctors and the public also carried.

As a stream of citizens stepped to the microphone to make suggestions or ask questions, the audience realized it lacked fundamental information about the hospital's inner workings.

"Is it possible to even bring such a resolution?" asked West Tisbury resident Robert Potts, referring to a motion to urge the board to retain Dr. Koehler.

"Before we discuss a whole lot here, some questions need to be addressed. Who is on our hospital board? Who owns the hospital? How does it run itself?" asked West Tisbury resident Richard Knabel.

"Dr. Koehler would like to keep it on a non-personal level. I would like to hear from the board," Oak Bluffs resident Chuck Sanders said.

Eyes turned to a cluster of trustees sitting with Mr. Burchill, and the audience waited for a reply. Some citizens even pleaded with the board members to speak up, but Mr. Gregory reminded the audience that everyone in attendance came voluntarily and could speak voluntarily.

Some minutes later, Martha's Vineyard Regional High School principal Margaret (Peg) Regan approached the microphone.

"I'm a member of the board, and I'm a parent and a patient. What I would like to do is listen. What's at stake for you is at stake for me," Mrs. Regan said.

But as the other board members remained silent, some residents grew visibly frustrated.

"The hospital is our lifeline. We depend on the hospital. It's the board's responsibility to give us answers. Somehow it all mysteriously goes back to the board. They always lean on us when we need money," said Aquinnah resident June Manning.

"You need to come out of the closet. It's not prestigious to be on the board anymore," said Oak Bluffs resident Eric Williams.

"You are entrusted with managing the most important institution we have on this Island. For God's sake, don't send us home with no indication that you will do everything in your power to deal with the Koehlers in the best way possible," Mr. Sanders said.

"You have citizens asking for answers, and the newest member of the board steps up. If you don't want to lead, step out of the way," Dr. Richard Koehler said.

"Everyone in this room is wanting something to happen, and I'm afraid nothing will. I'm afraid we'll get out of here tonight and the board will say, ‘Whew, we got out of this one.' It's like a mystery. They don't want to seem to step forward," said Edgartown resident Joe Whitney.

Some residents were prepared to accept some of the blame themselves.

"It's important not to demonize the board. Maybe we haven't been involved enough. I know I haven't," said West Tisbury resident Simon Barnes.

"I don't know how the board can make decisions if they don't know what we want. We can't expect an expert to come in here and solve our problems. God's too busy," said Tisbury resident Linc Hansen.

As the night drew to a close, citizens pushed two motions to recommend that the board do anything in its power to retain Dr. Koehler. Another motion passed urging the board to rescind its acceptance of Dr. Koehler's resignation.

Minutes before the scheduled end of the forum, hospital board of trustees chairman Fred B. Morgan stepped to the microphone.

"We came here to listen tonight. There are only a few board members here tonight - and believe me, we've listened," Mr. Morgan said.

Mr. Morgan then invited the public to attend a community meeting planned for after the board of trustees meeting on March 23. He promised that the board would address any questions from the public at that time.