More than half of the psychiatrists at New Hampshire Hospital will likely no longer work there in two weeks when Dartmouth-Hitchcock assumes operation at the state-run psychiatric hospital.
The 12 psychiatrists and advanced practice registered nurses set to leave warn that staff turnover threatens patient care.
“A lot of what we do is building trust,” said Dr. Matthew Davis, who has worked for four years at New Hampshire Hospital. “I am deeply saddened.”
On Wednesday, the Executive Council approved a four-month contract extension for psychiatric services at the hospital that takes effect July 1. It shifts control from Dartmouth College to Dartmouth-Hitchcock, a transition that has spurred the ongoing labor dispute.
State officials said they are confident the hospital in Concord will be fully staffed and operational through the summer. Dartmouth-Hitchcock said it has replacements lined up, but declined to say who or how many.
“Obviously, we have a public responsibility to ensure the services at New Hampshire Hospital are uninterrupted,” said Department of Health and Human Services Commissioner Jeff Meyers.
While most staff at New Hampshire Hospital are state employees, 19 psychiatrists, advanced-level nurses and administrators work there under a state contract that expires June 30.
Dartmouth College’s Geisel School of Medicine has had the contract to staff New Hampshire Hospital since 1988. Amid a reorganization there, Dartmouth-Hitchcock is seeking to take over, but only seven of the hospital’s current psychiatric staff have signed on to work for the provider.
The remaining 12 – including Davis – said Dartmouth-Hitchcock has been unwilling to negotiate terms of employment, and proposed reduced time-off and retirement in its benefit packages.
Now the physicians are being shown the door. Even if offered employment by Dartmouth-Hitchcock now, some psychiatrists said they would decline.
“I’m disappointed,” said Dr. Katya Hurst. “I hope that the psychiatric services will continue and patients will be taken care of.”
The state has yet to award the five-year contract. Meyers said the extension gives the state time to re-bid the contract if Dartmouth-Hitchcock can’t meet the requirements. The provider is still recruiting the staff it needs to fulfill the terms, officials said.
Hospital CEO Bob MacLeod warned councilors that a delay or rejection of the contract extension Wednesday could force the hospital to cut back on admissions. Patients are often admitted to the 158-bed hospital involuntarily because they’re experiencing serious behavioral health issues. New Hampshire Hospital frequently has a wait list, and on Wednesday it was more than 40 people long.
All five councilors voted in favor of the extension, saying they want to ensure patients’ access to care. But several raised concern with employment practices, and said they hoped the dispute would be resolved.
“I object pretty strongly to some of the employment practices that I believe we have seen from Dartmouth,” said Councilor Chris Pappas, a Manchester Democrat. “A number of qualified physicians . . . haven’t been afforded the opportunity to negotiate the terms of their employment.”
The five councilors penned a letter to Meyers after the vote urging the department to reopen the bid process, according to Republican Councilor Joe Kenney. “It allows us to have more options,” he said. The group of 12 psychiatric staff, including Davis, have formed a practice group to try and compete.
Democratic Gov. Maggie Hassan said the state is caught in the middle of the dispute. The contract also provides physicians at the Sununu Youth Services Center and Glencliff Home.
“I understand and value the people who are in the midst of a dispute with Dartmouth,” she said. “But I think that dispute cannot put at risk the people we are caring for at New Hampshire Hospital.”
The staffing changes at the hospital are the product of a major reorganization at Giesel that has shifted medical school employees to Dartmouth-Hitchcock payrolls.
The medical school laid off the hospital staff effective June 30, Davis said. Dartmouth-Hithcock rescinded its offers of employment to the eight psychiatrists and four advanced-practice nurses in early May, Davis said, when they refused to sign letters of intent pledging to work for the health care provider.
“There was nothing to sign really. They gave us offers without any details, they would not negotiate,” Hurst said. “We’re not resigning, we’re being laid off.”
John Kacavas, Dartmouth-Hitchcock’s general counsel, said the provider is prepared to fully staff the hospital this summer and employees will come from within.
During the transition, Dartmouth-Hitchcock extended employment offers to 182 physicians in the medical school’s department of psychiatry, and 145 accepted, he said, including some at New Hampshire Hospital.
“A small group didn’t accept our offer,” Kacavas said. “The overwhelming majority of people currently working at Dartmouth College are simply moving over to Dartmouth-Hitchcock.”
Darmouth-Hitchcock is still recruiting more staff to fulfill the contract terms. The focus is patient care, he and others said.
“The people that will be working at New Hampshire Hospital are really fully qualified excellent psychiatrists and nurse practitioners,” said Dartmouth-Hitchcock Chairman of Psychiatry Alan Green. “Providing psychiatric care is really important.”