Friday, November 30, 2012

A Wonderful Legacy Remembered: The End of Catholic Health Care In Our Region

This week marks the end of Catholic healthcare in our region. With the purchase of St. Joseph’s Medical Center by a non-denominational hospital company, a 148 year legacy of service is finished. I spent three years in Catholic healthcare in Boston and that company, Caritas Christi, is also a thing of the past, having been purchased by venture capitalists.

The reality is that we have too much hospital capacity in Baltimore. The owners of St. Joseph’s, Catholic Health Initiatives (CHI) of Denver, Colorado, had only one hospital in the area and it was losing a lot of money. CHI is a very large company with $9.65 billion in annual operating revenues but after a number of years of losing money in Towson, they decided to divest themselves of St. Joseph’s. CHI is a mission-driven organization and they are also realists. It appears that the company could only rationalize losing millions if they could prove that there was an unmet need. With all of the excess hospital beds in Baltimore, they could not justify the need so they got out. Now, a smaller hospital company is the new owner.

What a long way from the reality found by the Sisters of St. Francis of Philadelphia in 1864 when Mrs. Catherine Eberhard donated three row houses on North Caroline Street to be used for the sick and infirm. In that era, there was not much available to cure disease. Hospitals were started as a place to care for the sick who were also poor. Those with means were cared for in their homes by their families. The Sisters of St. Francis and others who joined with them in this noble mission dedicated themselves to helping others in their time of need.

In 1870, the State approved the Act of Incorporation to create the Saint Joseph German Hospital and in 1872 a new facility with that name opened at Caroline and Oliver Streets in Baltimore City. During the 20th Century, with the advances of modern medicine, the hospital grew and changed and in 1965 (the year of the opening of GBMC), St. Joseph’s moved to Towson. In 1981, the hospital became a part of the Franciscan Health System and they began doing open heart surgery the next year. In 1996, St. Joseph’s became a part of CHI and continued their growth in heart and orthopedic procedures.

Everyone in Baltimore knows what happened next with the governmental investigation and the accusations of unnecessary procedures. What has not been discussed is how the hard-working nurses, doctors, and other clinicians kept serving patients. Unfortunately for them, the business model that St. Joseph’s had chosen is hard to make work with so many hospitals pursuing the same model, and the American people and American businesses are desperate for a new model. You see, building a lot of hospital beds and waiting for people to get sick to use them, or only providing a lot of elective procedures because that is where you make the money, has led us to our national predicament where we are bankrupting our federal government, our state government and making it difficult for businesses to provide health insurance to their people. The new model, a system of health care that works to keep people healthy and limits the need for patients with chronic disease to be admitted to the hospital, requires different capacities and capabilities.

The biggest capacity that is required of the new model is primary care. In the Greater Baltimore Health Alliance, (our system’s Accountable Care Organization) we now have close to 100 primary care providers, many of whom are working in Level 3 patient centered medical homes with care managers, extended office hours, and a fully functioning patient portal, among other things, to keep people healthy. None of these things are focused on by hospital companies using the old model, like St. Joseph’s.

It is sad to see the end of the legacy of the dedicated Sisters of St. Francis and all of the hard working physicians, nurses, and others who worked with them on a mission of service to others. We know however, that their spirit lives on in those who embrace the new model of service and who are willing to let go of the old model where filling hospital beds and focusing on services that make money were acceptable endpoints in and of themselves.    


  1. FYI. Catholic healthcare is still in Baltimore, just not Towson. There is Bon Secours in the heart of West Baltimore. It is struggling to survive, but the Sisters of Bon Secours are still at the hospital everyday. They are also trying to do more than just keep hospital beds open, but try to help people on a basic level. Also, there is St. Agnes,run by Ascension Health, the nation's largest Catholic & non-profit system. Thanks for your blog, I read it often.

    1. Towson has and will continue to have a Catholic hospital. St. Joe's isn't going anywhere Dr. Chessare.

    2. I think my use of the word "region" may have confused some people. I know of the great work at Bon Secours, Mercy, and St. Agnes. I probably should have used community.

  2. What about Mercy Hospital? Last time I checked it was a Catholic affiliated hospital.

    1. Correct - and St. Agnes as well. Not sure where his fact checking team was on this one!

    2. Fact Checking Team...seriously? You may have missed the point I dont believe the articles full purpose was to give a full blown list of Catholic Hospitals in the area.

  3. Dr. Chessare and others,

    St. Joseph Medical Center (SJMC) has NOT divested themselves of their Catholic foundation, nor their Catholic-based mission and model of service, simply due to ownership change. In fact, Archbishop William E. Lori, after meeting extensively with the new leadership of SJMC, has deemed their commitment to the Catholic-based model of service more than satisfactory, and subsequently, has allowed them to officially maintain their Catholic status.

    Your blog is entertaining and generally informative, however, it should be understood that it is a marketing piece meant to elevate the perception of GBMC.

    While many of the Internet's "editorial" outlets are not subject to the same standards of ethical and fact-based reporting, it is nonetheless important to maintain a responsible approach to the information presented to the public.

    - S.H.
    Towson, MD

  4. I was surprised at the title of this post. It's misleading and inaccurate.

    In a statement last week, Archbishop William E. Lori, Archbishop of Baltimore said:

    “St. Joseph Medical Center has provided quality, Catholic healthcare to people of all faiths for over 145 years. The hospital’s Catholic identity is pervasive in virtually every aspect of its operation. This agreement will ensure that St. Joseph’s will continue this long tradition of providing faith-filled care throughout this new chapter in the hospital’s storied history.”

    Source -

  5. As a St. Joseph employee, let me assure you that we are still at Catholic hospital. Archbishop Lori made the final determination last week and it was covered by the local papers in town. We are proud of our legacy with the Sisters of St. Francis of Philadelphia and they are very much a part of our day-to-day activities. I encourage you to come walk the halls and feel the Catholic identity and mission that is alive and well. Our Catholic identity is also of crucial importance to UMMS. They have made it a priority to understand what being a Catholic hospital means.

    I know GBMC wanted to buy our hospital. Perhaps this column is bitter grapes. Perhaps you're nervous about what this might mean to your hospital. I urge you to get the story straight before you comment on the history and future of other institutions.

  6. Why do you insist on constantly encouraging people to think that a hospital or health care system should be responsible for keeping people "healthy"? When someone enters a doctor's office, it is their own responsibility to learn about their disease process and adjust their lives accordingly. We are all capable of learning and being responsible for ourselves, and it is a great diservice to someone to assume they are incapable of doing so. Sort of like assuming someone will never be able to support themselves financially, and encouraging dependence on the system for their income, don't you think?!

  7. So we post comments on Dr. Chessare blog (which is great), but do so anonymously. Im just saying...


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