When the Duke University Health System struck a deal to take over Raleigh Community Hospital in September of 1998, doctors and employees at the city's smallest hospital were wary of potential changes Duke could make-including money-saving tactics like cutting jobs and downsizing services. But more than a year later, Raleigh Community officials said Duke has fostered employee morale and facilitated overall improvement.
Jim Raynor, chief executive of Raleigh Community, said he expects Raleigh Community will improve its profitability by about 7 to 10 percent this fiscal year.
Specializing in psychiatry, general medical care and surgery, Raleigh Community has approximately 500 doctors who work at the hospital or others; 12,000 surgeries are performed annually.
Although Rex Health Care and WakeMed have bigger networks, Raynor said Raleigh Community "is now in the growth mode." Overall activity is up 10 percent, and birth rates have increased by 16 percent.
"There have not been a lot of major changes. The biggest [change] was the improved morale... of the long-term employees," said Dr. Kirk Faust, who was chief of staff at Raleigh Community from 1996 to 1998.
Faust, who performs general surgery at Raleigh Community, Rex and WakeMed-the three big players in the city-said Duke's leadership is much different from that of Raleigh Community's old owner, Columbia/HCA. "[Columbia] took a big hit in the media and that hurt the morale of the place," he said. Columbia/HCA, the largest U.S. hospital chain, downsized Raleigh Community and made large cutbacks to the hospital.
Raynor said Duke has acted differently in its first year. "Duke is allowing us to put the profits back into the hospital itself... and has been very good about letting us reinvest," he said.
Dr. Ralph Snyderman, president and CEO of the Health System, said he is pleased with the results from the first year of operating Raleigh Community. "The goal of the purchase of Raleigh Community Hospital was to develop a presence for the DUHS in Wake [County], a large and fast-growing neighbor," he said.
Nonetheless, employees and physicians were initially fearful of drastic change. Raynor said the medical community's biggest concern was that Duke would bring in its own doctors and compete with local physicians.
Duke did bring in doctors to strengthen certain departments of the hospital, including cardiology and neonatology, since there was no staff support already in place.
In particular, the neonatology area has undergone a significant transition. "We didn't feel comfortable delivering babies below 30 weeks," Raynor said. With 24-hour neonatology service, the hospital has become what Raynor called a full-fledged neonatal intensive care nursery.
Raynor said that other "visible changes" have taken effect since Duke came in. He pointed to the renovation plans for the intensive care unit and obstetric areas, as well as the replacement of a 10-year-old magnetic resonance spectrometer with a new $2 million machine.
Although he would not go into specifics, Raynor added that the hospital is interested in the growing market in North Raleigh, where both Rex and WakeMed have purchased new land for facilities.
Duke officials believe growth and expansion come with Duke's involvement with Raleigh Community. "Traditionally Duke had a 3 percent market share in Wake County, and that's not something we believed we could live with in the long run," said Michael Israel, CEO of Duke Hospital.
Snyderman said services will soon be added at Raleigh Community. "We are now in a far more advanced planning stage and will likely accelerate the pace of adding services there," he explained.
Snyderman said DUHS is "mindful of the need for us to fully understand the needs of that community before we act."
Duke has benefited from the slow but steady success of the hospital, but Snyderman said DUHS faces certain challenges.
"[We must] remain synergetic with the needs of the area and with the physicians who practice in Wake as well as our clinical faculty," he said.
Raleigh Community, according to those who are part of the growth process, is holding its own in the medical community-with Duke's continued support.
"When Duke bought [Raleigh Community]," Faust said, "they brought some name recognition and some integrity to the place."
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