WHMC temporarily tables closure of obstetrics services

COLFAX —The Whitman Hospital and Medical Clinic (WHMC) Board of Commissioners held a Special Meeting at 5:30 p.m. on Wednesday, Mar. 7, to hear further public comment on the decision to close the hospital's obstetrics services, which was made at the Wednesday, Feb. 21 commissioner meeting.

Several community members gathered in the Colfax Library Center to hear, and those registered to speak stated their thoughts in three minutes.

WHMC Board of Commissioners President Georgie Leinweber started the meeting by reiterating that the purpose of the meeting was to receive additional input and re-evaluate the decision to offer obstetrics services no longer.

"I would like to make a motion that the board's action on Feb. 21, 2024 to discontinue OB services be put on pause until sometimes in the future," said WHMC Commissioner Kathy Wride.

The movement was seconded and unanimously carried by the board.

Leinweber opened the floor to those registered to provide comments and called from the list of those who had to speak.

The first to speak was MD MPH Dr. Margaret Leland, accompanied by Dr. Peter Edminster, MD.

Dr. Leland thanked the board for having the meeting, given that it is a complicated topic, and acknowledged that their job is difficult. "You're using your skills and life skills, and your opinions on the community, in order to make the decisions that you can," she said, noting that sometimes that is with severe time limitations and conflicting information. "I understand that your job is very hard," she said.

Dr. Leland specifically spoke to the topic of the laws set forth by Washington State regarding abortion. Leland explained that the State of Washington and the actors working underneath the state cannot discriminate between managing an elective abortion in a patient and managing a miscarriage or medically induced abortion. "That is what this all came from," she said, noting that, however, does not force them to perform abortions.

"No one can force me to do a procedure that I'm concerned about, that I'm not trained to perform, or that I feel is not indicated," Dr. Leland said, adding that her conversations with her patients in the clinical exam room are private. "I'm really just asking all of you to trust that I am providing appropriate medically accurate advice for all of my patients, including my pregnant patients."

Dr. Leland told the public in attendance that if they want to know if she will be performing elective abortions, the answer is it depends on the patient, their health, their gestational age, and a host of other factors. "That is between myself and the patient; and the board, the community, the hospital staff, etc., are not allowed into that conversation," she said.

She also mentioned that no one in the obstetrics department or within 50 miles of her is equipped to perform third-trimester abortions. "These are medically complex patients that require an advanced level of care, and that is not indicated in our facility or anywhere within 50 miles of here," Dr. Leland said.

Dr. Leland mentioned that rural obstetrics is a very difficult practice. Data and research show that women and infants suffer the consequences of limited access to care. "I feel the closing of the OB department would not only be a detriment to the community, but could harm the patients that I care for so deeply and have worked so hard to manage," she said.

Several people, including Patty Cammack, spoke regarding their opposition to the idea of the obstetrics clinic closing. "We need to think about the long-game and not just the short-term decisions," she said.

"I'm concerned that with the loss of these services that, our hospital is going to continue to decline to the point where it's no longer going to be a resource for our community," said community member Christopher Clausen.

"This community relies on the hospital for the care it provides," Tick Klock Pharmacy owner Nathan Johnson said, adding that the closure would cause a trickle-down effect leading to the loss of current established providers.

St. John City Clerk Shani Hergert read the City Council of St. John's letter regarding the possible loss of the smaller town clinics.

While many opposed the decision to close the service, WHMC Anesthesia provider CRNA Nikki Riley supported it. "I'd like to start by saying that I'm not anti-OB necessarily, but what I am is pro-quality care at Whitman Hospital," she said.

Riley said that the hospital does around forty births a year, which are divided between three doctors, three anesthesia providers, and about six obstetrics nurses. She noted that this is about 16 births, per doctor, per year.

Riley mentioned that at the last meeting, the CNO presented an outline of the volume that hospitals need to achieve to maintain quality care. "Our OB numbers are not even close to meeting the minimum numbers," she said.

Riley said that if the OB continues to have deficiencies, the hospital could lose federal funding, and if that is lost, she doesn't know how long the hospital can stay open. "We need to look at the bigger picture and the community that we serve as a whole," she said.

"The population of Colfax is about 2900 people, and the population of Whitman County outside of Colfax and Pullman is about 12,000. "You can assume that we provide care for approximately 15,000 people who need more than just OB services," Riley said.

Riley mentioned that the hospital offers so much to the community other than obstetrics. "I personally don't want to bet my community hospital on 40 births a year," she said, noting that a large portion of the community can't just move when resources go away.

"This is why I think we need to look at the future of Whitman Hospital that doesn't include OB. I want there to be a future for Whitman Hospital," Riley said.

In an interview with the Gazette on Tuesday, Mar. 5, WHMC Manager of Administration Services Laurie Gronning confirmed that the hospital, as well as the twenty-six other public hospital districts, received a notification from the State Attorney General needing to know how the hospital was going to comply with the Washington State Reproductive Privacy Act. (RCW 9.02)

The Privacy Act states that every individual possesses a fundamental right to privacy concerning personal reproductive decisions and includes statutory protection for abortion.

Gronning said the letter brought about the closure of the obstetrics services. "We did reply to that letter, with the intended decision made to the board," she said, adding that the hospital requested a 30-day extension to get public comment.

"None of the medical staff or obstetric staff were aware that this was a topic of the meeting," Edminster said, adding that at that point, they weren't allowed to speak.

The board did not decide on the future of the obstetrics services at the Mar. 6 special meeting, and the next regular business meeting for the WHMC Board of Commissioners is at 5:30 p.m. Wednesday, Mar. 20, at the Administration Annex building.