Letters to the Editor
To the Editor:
When I heard the news that the M.S.P.C.A. shelter in Edgartown will close its doors in May, I was devastated and sad, which turned to anger. How can an organization like the M.S.P.C.A. abandon its responsibilities to the animals on Martha's Vineyard? What will happen to all the homeless and lost cats and dogs and those given up because their owners can no longer afford to feed them? And what will happen to animals who need to be cremated because of old age or illness?
When my husband and I moved back to the Vineyard in 1978, I met A'Bell Washburn, and we discovered a mutual love of animals and concern about the conditions at the old M.S.P.C.A. shelter. Together we began to do what we could to find homes for all the cats and dogs that found their way to the shelter to live in sub-standard conditions because the M.S.P.C.A. had all but abandoned their responsibilities even then. For years Mrs. Washburn and I collected funds and started the idea for a new shelter. It took years, but the M.S.P.C.A. finally agreed to build us a new shelter. Out of that concern and hard work was the establishment of P.A.W.S., which was funded by donations and run by dedicated volunteers. The new shelter was built in the early 1980s and has been run successfully ever since. And now they want to abandon it and the animals again. The consequences of such an act are unthinkable.
I urge everyone who loves animals and who has ever adopted a pet from the shelter to please express your unhappiness and regret to: Carter Luke, President, M.S.P.C.A., 350 South Huntington Ave., Boston, MA 02130 or by email at www.mspca.org and write to your local papers, the Vineyard Gazette and the Martha's Vineyard Times. Our voices must be heard for the animals who cannot speak for themselves.
Janet A. Norton
To the Editor:
We were saddened to learn of the closing of the three MSPCA shelters, especially the one on Martha's Vineyard. And, although the Vineyard Veterinary Clinic is a tenant in the front building of the MSPCA property, our privately owned veterinary business is not affected by the shelter closings. We will continue to serve our patients' and clients' needs for high-quality veterinary care, and will work with the many other Island animal welfare organizations.
Drs. Williams, Buck, and I, along with the entire staff of the Vineyard Veterinary Clinic look forward to serving you for a long time to come.
We are hopeful that a quick solution can be developed and that the building behind our clinic can once again be a working animal shelter to help Island pets in need of homes.
Bridget Dunnigan MS DVM
Vineyard Veterinary Clinic.
To the Editor:
What will happen to all the abandoned animals on Martha's Vineyard when the MSPCA closes the shelter? It isn't like the owners can take them to another nearby town and drop them off without going off-Island. This is tragic, as it will lead to many homeless pets. The MSPCA should live up to its name and reconsider its decision to close the Island shelter. By the way, I once acquired a special Siamese cat from the Island MSPCA. How could they deny the opportunity to adopt shelter cats and dogs to those who want to give animals a second chance for a forever home? Our four-legged friends deserve better.
Doctor urges, let them hear from you
To the Editor:
I was glad to see Nelson Sigelman's article on a subject that is very close to my heart [Feb. 5, Surgeon Koehler would return; MVH says he's not needed]. I would, though, like to offer some clarifications about the process of physician staff membership at hospitals, and salaried versus private practice physicians.
To start with, hospitals are not country clubs, or poker groups, that select members based on social acceptability. Hospitals also are not department stores that post physician job positions on the break room wall. It just doesn't work that way.
As for "...following the rules...," in most any hospital other than large HMOs such as Kaiser Permanente, or in hospitals that are full-time university affiliated tertiary care training centers, medical staff membership is governed by the medical staff itself. An application is submitted (having been given), and the applicant is examined as to his or her credentials meeting the credentialing requirements set forth in usually two documents, the Rules and Regulations, and the Bylaws of the Medical Staff. If the applicant has the appropriate credentials and is prepared to meet the terms set forth in the above two documents, then the physician's application is put to a vote by the medical staff.
This process is the same whether the applicant is being salaried by the hospital, or is applying as an independent practitioner. If the medical staff does not perceive a need for the applicant, they may turn down the application on that basis, provided there is no conflict of interest that entered into such a decision. But even that is unusual at a community hospital setting. And any applicant would have done some fact finding as to medical staff opinions before even requesting an application.
And regarding me applying for "replacement staff": despite numerous written - and too numerous to count verbal - communications, it was never suggested to me, much less offered, to apply as a first measure for "replacement staff." The singular response I have received has been: "We don't need another surgeon".
There's also a lot of misinformation going on here about private practice surgery versus hospital salaried surgeons. I am not seeking employment, or any other financial incentives, from the hospital. I run my own business at my own expense, and my staff position would be a zero cost item to the hospital. Every dollar I generate in hospital charges for surgeries I perform goes 100 percent to the hospital. (Such is not the case when a salaried surgeon is involved, since charges are offset by the salary of the surgeon, who is paid by the hospital.)
I have never in my entire career practiced in any other setting than that of a non-profit, hospital-based scenario. (Well, maybe except in a Marine Corps SSC (MASH) unit in Desert Storm). I have no intention of any kind to start a private surgery center anywhere. My intent is solely to bring surgical cases back to MVH that are not now being performed at MVH. More cases equal more money for MVH.
As to needing another surgeon or not, surgery is a major income producer for hospitals via the hospital's charges for hospital services. If the surgeon is salaried, then the hospital would collect the surgeon's fees as well, but this is a comparatively very small amount. (The ratio is about 10:1 for hospital charges versus surgeon's charges, if not more.) But these fees will barely balance out what the surgeon is getting paid by the hospital. The real money to be made is through the hospital charges, particularly at an institution like MVH, which rightfully enjoys favorable insurance reimbursement due to its "Critical Access Designation."
So again, since I cost MVH nothing, even if I do one case more that wasn't going to get done at MVH, the hospital makes money it otherwise wouldn't have made. It's really as simple as that.
For the uninsured, I will guarantee that no one will be turned down by me for lack of ability to pay. And remember, when a salaried surgeon operates on an uninsured patient, the surgeon is still getting paid by the hospital.
I support the excellent job that I hear both Dr. Pil and Dr. Fraser have been doing. While there may be some procedures which I perform that they do not, I'm sure the same is true in reverse. Such is the nature of general surgery, which is why a team approach would be in the best interest of the patients at MVH, I believe.
Drs. Pil and Fraser are totally entitled to time off. I absolutely could not agree more, particularly in the summer. Two surgeons for a population in excess of 100,000 is a considerable burden. I should know. I was essentially on call seven out of 10 days, for all eight years. This is why I've been offering, in writing as far back as August of 2007, to cover the surgical practices of Drs. Pil and Fraser when they're off, for free. The administration's response, then and now: "No thank you."
After I resigned (which was one of the hardest decisions I have ever had to make, not just for me but for my family and my practice), the management style of MVH was finally changed, along with the hospital's leadership, and by everyone's measure for the better. Today, I completely support John Ferguson, who I unfortunately never had an opportunity to work under, and I agree that he and his team have been a huge success. I have stated to the present administration, in writing and in person, that they are to be congratulated on such a remarkable turnaround of MVH.
In retrospect, I think I should have showed more patience, and I should not have pushed so hard for immediate changes, even though things seemed pretty dire at the time. Maybe those changes would have come, maybe not. But the legal threats were the absolute final straw. Were it not for one particular letter from a Boston law firm, things might have been different.
If I am allowed the opportunity to apply for the medical staff at MVH, I guarantee I will be generating money for the hospital the old-fashioned way, by working hard and taking nothing from the hospital.
I sincerely hope that everyone who has a stake in MVH, seasonal and year-round residents alike, will make their voices heard to the present hospital's leadership. That leadership and the doctors, nurses, therapists, technicians, social workers, and everyone else at MVH all deserve your support. They also need to hear your concerns. Having open ears and open hearts is good medicine for us all.
Richard H. Koehler MD
Dr. Koehler a win-win
To the Editor:
It is with great interest that I read your recent coverage of Richard Koehler's ongoing attempt to re-establish his practice here. Given the number of reader posted comments and their impassioned tones, this is obviously an issue dear to our hearts.
Nelson Sigelman did a credible job in reporting upon both "sides" of the story. But the "not needed" headline, representing the administration's stand, is hard to fathom. Just a few weeks ago the Vineyard Gazette reported that the MVH had showed a big drop in revenue, mostly due to a decline in surgeries.
The obvious unreported fact is that many Islanders, myself included, go to the mainland for their various surgeries - be it to Jordan, Mass General, Faulkner, or points in between. Were Dr. Koehler permitted to perform his masterful practices here once again, he could provide more than $200,000 a year to the hospital, without needing a dime from them, as Dr. Koehler has stated.
To deprive us of his talents for inexplicable, mostly administrative disinformation is hard for me to swallow. I really hope that when our grand new hospital is ready to open next year, Dr. Koehler will be available to us once again.
Driving to Plymouth is always an option (or to Nantucket, where he also works periodically), but it can be a logistical nightmare, especially under dire circumstance. In these turbulent economic times, I keep hearing the phrase "let's keep it on the Island." That means our business, commerce and hard earned money. This is a very worthy concept, and worth abiding by whenever possible. Next time I need some delicate surgery, I would love to keep it here. Bringing Dr. Koehler back would help provide that win/win situation.
Martha's Vineyard Commission modifies FY 2010 budget
To the Editor:
When the Martha's Vineyard Commission adopted its budget in January, as required by its enabling legislation and bylaws, it committed itself to review the budget again before certifying it to the towns. On February 5, the commission amended its budget, with additional cuts to expenses so that the assessments to the towns are now level-funded.
With respect to salaries, our aim is to make sure that our employees are treated in a similar way to other public servants on the Vineyard. It appears that the Martha's Vineyard Commission's proposed salary increase is currently right in line with the average proposed salary increases in towns and other public entities, based on a preliminary compilation of data. As definitive information about their salary increases will not be available until town meetings take place, the commission plans on reviewing salary levels in May, before they go into effect for the next fiscal year.
The commission also committed itself to review its budget development process for future years, to make it more timely, clear, and responsive to town boards and citizens.
Martha's Vineyard Commission
Get the bivalve right
To the Editor:
I have to admit I don't read The Martha's Vineyard Times quite as often or as thoroughly as I might, so perhaps this is an observation rather late in coming.
Yesterday, I noticed "Reel Picks," your movie review section, states that the movie ratings are in the form of clams, ("5 clams, highest"). Different to be sure, but okay, it's cute and after all we live on an Island surrounded by seafood, which presumably most of us know quite well.
So why is it that your graphic depiction of the "clam" is actually a scallop?
Fisherman's advocate formed
To the Editor:
Recently a group of fishermen met with Sen. Rob O'Leary and state Rep. Tim Madden to discuss a bill that would ban commercial fishing for striped bass. Kudos to you gentlemen for taking the initiative.
Senator O'Leary has suggested that Vineyard fishermen get organized with Cape fishermen. In response to a fisherman's complaint that fishermen from neighboring states fish Massachusetts waters, but those states do not allow Massachusetts fishermen to fish in their waters, he told the fishermen present, "You ought to get organized with the Cape fishermen." I suggest we do just that, get organized.
I and others here on Cape Cod have agreed to start the Cape and Islands Inshore Fishermen's Association (CIIFA). This association's primary objective will be to act as an advocate for the small-boat, hand-gear fishermen of our area and representation to the Massachusetts DMF, the marine fisheries commission, and NEFMC.
While this association is still in its inception, we hope that it will be an effective voice for a large group of fishermen who now have no formal, united voice to represent them on the many issues we all deal with as fishermen.
There are many issues that need to be resolved with Mass. DMF and NMFS regarding access to our fisheries. This association will benefit all of us who make our living in part or in whole from commercial fishing here in Massachusetts.
For more information, please visit: ciifa.capecodfisherman.net or email us email@example.com
To the Editor:
I would like to extend a heartfelt thank you to Patricia Cliggot, who has been supplying wonderful gourmet meals to Island hospice and families in our community. The dishes are beautiful and notably full of love. Thank you so much, Patricia; your time and effort is incredibly appreciated.
Why is KI being offered?
To the Editor:
Why is there an ad in this paper announcing the distribution of "Potassium Iodide (KI) for use during a Radiological Emergency"? Could it have something to do with the fact that the Pilgrim nuclear power plant is getting dangerously old, and if it accidentally releases radioactive materials, potassium iodide will reduce our level of radiation poisoning?
Please report on this. And while you're at it, please compare the life cycle health risks of nuclear plants to those of oil, coal, natural gas, and wind powered generators.
In addition to KI pills, maybe we should be receiving filters that remove sulfur from air, mercury from fish, and wind turbines from the horizon?