David & Goliath: Top Down vs. Bottoms Up

I promised to keep you updated on my own evolving case study/soap opera as our local community members on the scenic Boothbay, Maine peninsula struggle to save our local hospital.

St. Andrews Hospital is accessible by road, sea, and air (helicopter); which is useful for our local Coast Guard. Photo: Courtesy of Dr. Judy Stone

This is a classic tale of top-down corporate planning that took place behind closed doors for over a year with a series of “experts” and management strategists, and employee sub-committees, with NO input or outreach to the customers/patients/families/community members/town managers, and volunteers whose lives would be impacted. Of course, the top down folks have a strategic objective. They want to close down the annoying healthcare facilities in hard-to-reach places at the bottom of peninsulas and replace them with a gleaming new facility on well-traveled (and tourist-jammed) Rte. 1 which runs up the spine of the coast. It makes business sense. But it doesn’t make sense for the people who actually live, work, and fish for a living in a coastal community.

When the decision to close down our local Emergency Room and Critical Access Hospital, St. Andrews, was announced in late July as a “done deal,” you can only guess at the public outrage and outcry. Unfortunately, things have gone downhill from there.

In the Goliath corner, the management of Lincoln County HealthCare (LCHC is part of the behemoth, MaineHealth which has Portland’s Maine Medical Center as its linchpin) is barreling ahead with their plans to shut down the hospital on April 1st, and pacifying the local community members by starting a too-little-too-late Community Advisory Board. This is a classic case of how NOT to engage with customers. They recruited this Advisory Board from the people who are already on their side, and this group is a token group that will meet once a month to “advise” LCHC on how best to communicate with (e.g., brainwash) the locals.

In the David corner, the selectmen from all 4 towns on our peninsula have formed a rapid action Task Force. It meets in 2-hour open meetings weekly with lots of community members showing up and participating. These meetings are broadcast on local cable TV and covered by the news media.

Fredi Luke--A Stalwart Local Activist

Community members with surprising skills (doctors, medical researchers, community healthcare experts, lawyers, corporate execs, top notch consultants—including yours truly) are crawling out of the woodwork and turning up in droves in working groups, mounting legal action, writing legislation, doing a business plan, doing an economic impact study, surveying the health and wellness needs of the community members and working together to produce a “Second Opinion” about the kind of services our aging community of 6,000 year-round residents and 20,000 5-months/year residents really need.                                      

Of course, money talks. Goliath has a lot. David has a little. What’s at stake is $30 million of health and wellness services and a $30 million hospital and retirement community situated in one of the most beautiful places in the world. It’s worth fighting for! Let the customers win!