Opinion: HCA/Mission's 'ruthless cost-cutting' damaged psychiatric care, run off doctors
ASHEVILLE CITIZEN TIMES | Guest Opinion by Steve Buie
September 22, 2024
The following guest opinion appeared in the Asheville Citizen Times on September 22nd, 2024
In 1987, I moved my young family to Asheville to take a job at Highland Hospital, a psychiatric hospital affiliated with the Duke Psychiatry Department. Highland was started in 1904 by psychiatrist Robert Carroll and received referrals from all over the East Coast. Dr. Carroll gave the hospital to Duke upon his retirement. Unfortunately, the department chair at Duke decided to sell Highland to Psychiatric Institutes of America, a chain of private psychiatric hospitals, to create an endowment for his department.
PIA already managed and had an option to purchase Appalachian Hall, the other psychiatric hospital also founded by psychiatrists, Mark and William Griffin, in 1931. Between the two hospitals, Asheville had over 200 inpatient psychiatric beds to serve WNC. Under corporate management, Highland Hospital was closed in 1993 and Appalachian Hall closed by the end of 1999. Two hospitals that served the region for a combined 157 years were closed after fewer than a combined 20 years of corporate management. When profit is the primary motivator, the needs of the community take a back seat. Two hospitals that provided excellent psychiatric care for close to a century were closed because they were not profitable enough.
Our region has suffered from a lack of psychiatric beds since the closing of those two hospitals 25 years ago. Patients have had to sit in the emergency departments of the region’s general hospitals, waiting days to weeks for a bed to open and have often had to travel outside the community to receive care.
To my sorrow, I’m seeing a similar process with HCA’ Healthcare's purchase of Mission Hospital. The profit motive takes precedence over service to the community. HCA’s ruthless cost-cutting measures have damaged staff morale and led to nurses forming a union and considering a strike. More than 200 hospital employed physicians have left, and 100% of the psychiatric physicians who were there prior to the purchase have left. The oncology group that provided state of the art cancer care has left. The neurologists who developed a best practice stroke center have almost all left. The ear, nose and throat surgeons have left. The urologists have left. The hand surgeons have left. Now, it’s time for HCA to leave.
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Steve Buie, MD, is a recently retired psychiatrist, former service line leader of psychiatry at Mission Hospital.
