Durham Regional Hospital's severe and widely publicized financial troubles have made some of its employees uncertain about the hospital's future. The hospital merged with Duke University Health System in July 1998 in an attempt to make it more solvent, but it now faces a serious $4.3 million deficit.
This downturn has raised some concerns among employees about promises from Duke, especially the "no layoffs" policy, a Duke pledge that no Durham Regional employee would be fired within the first three years of the merger.
Most employees at Durham Regional were very uneasy to talk about the issue and none were willing to go on record.
"I'm thinking about the latest developments," said an operating room employee, "but I'm not terribly concerned since there's not much I can do about it."
His words echoed a general sense within the hospital's staff that Durham Regional is losing some of the independence it had before the merger.
A long-time technician expressed concern over the latest developments.
"I think the budgetary loss is being played up to gain a greater control of the hospital by the DUHS," he said. "We used to have control over our own destiny-now we don't."
Mike Israel, CEO of Duke Hospital, maintained that there is nothing to be gained by manufacturing a crisis. He affirmed that DUHS simply bears the responsibility for operating the hospital, while the county commissioners approve the strategic plans.
However, Israel did acknowledge that in order for the commissioners to retain this power, the hospital has to make a profit of 3.5 percent of its operating budget.
"But even if someone thinks that we are Machiavellian enough to think up such a scheme," said Israel, "they should know that we pushed back the goal of reaching a 3.5 percent margin by three years."
In general, Israel said that although he understands why employees might be worrying, he was confident that Durham Regional's financial problems will be solved.
Some employees worried about the changing character of Durham Regional. Several nurses said they would not like to see Durham Regional go the way of DUHS, becoming more like a business and less personal.
Durham Regional CEO Richard Myers countered that the hospital is a business and as such has to be brought into alignment. "We simply cannot operate within a deficit," he said.
Furthermore, Israel added that DUHS is not like other hospitals in North Carolina. "We house some of the sickest patients and have 7,000 employees, which is more than the population of some small towns," he said.
More importantly, Israel reiterated that Durham Regional is not meant to be a "mini-Duke Hospital" and that both hospitals may grow even more personable as a result of the merger.
But despite the financial and emotional rollercoaster, the quality of care seems to have remained the same.
Jackie Forsythe, a patient, said she never had a bad experience at Durham Regional and that she hopes things stay that way. Other patients said they have seen no difference in the level of services offered since the merger.
On the part of the employees, a medical specialist summarized the mood best: "We just hope that Duke sticks to the promises," he said.
Israel responded to such concerns by first acknowledging them as appropriate given the hospital's desperate financial situation.
But he added that DUHS has not backed away from any commitments and that it now has administrators with past success actively engaged in finding solutions. A firm strategy for resolving the budget deficit is expected soon.
Israel also made it clear that sticking to promises is of great importance to DUHS and him personally." "My ability to do my job," he said, "depends on my credibility."
Israel encouraged all employees to feel free to contact management about any concerns through the existing "in-touch" system or direct contact. "They can send me an e-mail if they like," he said.
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