There will be no more babies delivered at Callaway Community Hospital after March 9.
On that day, the hospital will close both the obstetrics (OB) unit at the hospital and the obstetrics clinic that is part of Fulton Medical Clinic.
"This action is one of many ... that are positive actions to keep the hospital viable and make it a professional hospital meeting the community's needs," said Allen AufderHeide, CCH chief executive officer. "The market Callaway Community Hospital currently operates in does not make obstetrics viable."
AufderHeide said there were 90 births at the hospital in 2011, adding that the facility is currently on pace to do 96 for 2012.
"Statistics have shown it takes close to 300 deliveries a year to (for us to) break even," he said. "Since we are the only hospital in the community, we'd like to stay here and provide services the community needs. Statistically, those needs don't include obstetrics.
"There's going to be many other services we're going to try to continue and bring that have been proven with demographics and documentation to be needs."
Many of those needs, he said, involve "those specialties that affect the aging population," giving the example that Callaway experiences more issues with joints than the national average. According to AufderHeide, Callaway Community Hospital's service area's biggest area of grow is in age groups 55 and older, noting that most of the younger age groups are staying stagnant or even declining.
"We're working on a rural development loan to do a geri-psych (geriatric psychiatric) unit, we're going to try to increase cardiology, we're going to try to bring in rheumatology, we're looking at a limited orthopedics and we're going to increase our surgery services, as Dr. (Dilip) Parulekar is close to retirement," AufderHeide said. "We just formed an agreement with Columbia Surgical Associates. They started a clinic here every Monday - we already have a couple surgical cases scheduled for next week."
He said the hospital may also try to do a sports medicine clinic, "which we think will help the universities and schools with their sports teams."
AufderHeide said the hospital was able to absorb most of the personnel affected by the closure of the OB unit and clinic, but four positions - including that of Dr. Catherine McCray - were eliminated. According to staff at McCray's office at Fulton Medical Clinic, the doctor has been out sick over the past week and was unavailable for comment.
Although AufderHeide's reasoning behind the closure of the clinic makes sense, not everyone is satisfied that closing the OB clinic is the best option.
Kim Thomas, a longtime patient of Dr. McCray - who also worked with her as a nurse at CCH at one time - was not pleased when she was informed of the decision.
"I went to the clinic to check on an appointment and was told by her nurse they had just found out from the hospital they were closing the OB unit and gave them 30 days' notice," Thomas said. "Dr. McCray is one of the best doctors this community has had in a long time. She's one of only two doctors in this community that delivers babies, and there are no doctors in this town taking new patients, so what are women of this community going to do?
"I think the women and men of this community should not support Callaway Community Hospital as far as taking labs there or getting x-rays or other services if they're going to turn their backs on the women of this community."
AufderHeide countered that there are other options for women seeking obstetrics care in Callaway County - and not just traveling to Columbia, Jefferson City or Mexico.
"Callaway Physicians, which is associated with the University (of Missouri Health Care) system, is a family practice and they have physicians that do obstetrics," he said. "We have been giving (our patients) options in the community."
According to the Callaway Physicians website, doctors Heather Pierce and Laura Morris both list obstetrics as clinical interests.
Callaway Community Hospital trustee Rick Gohring said that although they do not take patients' concerns lightly, the hospital still is a for-profit business, and must act as such.
"If a business line is not making money and the (data) is saying it is not a need, we have to reallocate those resources," Gohring said. "Does that mean we're not sensitive to the citizens? We are, but we are for-profit and we need to get a return on our investment to remain viable.
"It's a fact of life that when you have competition, you have to establish your own niche if you're going to be successful, and what Allen and the hospital are doing is creating niches where we can meet the need. I hope the community realizes these are long-term positive changes."
AufderHeide agreed, adding, "I think it's important the community knows we are working on many positive changes as we change our business model to meet the needs of the community."
"We need to increase our viability so we can serve those needs for a long time," he said.