One year to the day that her predecessor was summarily dismissed as CEO of Martha’s Vineyard Hospital, Denise Schepici stood before a crowd in the Performing Arts Center at Martha’s Vineyard Regional High School Tuesday to talk about the hospital’s future.
Schepici, who took over in January, was engaging, offering anecdotes about her childhood growing up with an extended family that included her grandparents in East Boston, where she would walk to nearby Logan Airport. She was also lighthearted, noting that she is “younger” than her husband, a retired teacher, and learned to swim in Boston Harbor. She talked about making more in tips from her job as a waitress at Hilltop Steakhouse than she got in her first job at Salem Hospital. And she talked about her first visit to Martha’s Vineyard as a teenager: “I fell in love with this Island, and knew I would live here someday.”
The forum, which went beyond the 1½ hours set aside, was moderated by Peter Brown, who filled gaps in audience questions with some sent in by email. It was a wide-ranging conversation that touched on simple things like providing assistance to elderly patients who need help navigating the long hospital corridors (golf carts, anyone?) to the need for more primary-care doctors — something that Schepici has concentrated on in her first five months on the job.
They talked about the specific healthcare needs on the Vineyard — Lyme disease and proper diagnosis — and some of the worldwide issues, like substance use, that hit home on the Island.
“We know this is a process and it takes a village, right?” Schepici said of treating addiction. “We have services. We have to figure out how to weave them together and provide greater access.”
Schepici also knows she has to work to rebuild the community’s trust in the hospital, after Joe Woodin was abruptly fired a little over a year into his tenure at the helm. She was asked pointedly by Doug Ruskin of West Tisbury what made her confident she would still be around in a year, knowing that Woodin had been ousted.
“The predecessor thing. I’m not going to talk about that. I never met Joe,” Schepici said. “I just have to do my job. As long as I do my job, I’m going to be fine.”
She highlighted some changes on the board of directors, like the departure of chairman Tim Sweet, and told the crowd that there is no quota for sending patients from the Island to Massachusetts General Hospital, MVH’s parent hospital.
Alan Brigish, a West Tisbury resident who helped organize a group of concerned citizens after Woodin’s termination, asked about making even more changes on the board. “Many of those board members have been there for a long time,” he said, suggesting term limits. “Are we going to refresh this board?”
Schepici said she has a good working relationship with the board, and noted that terms are for three years. A new bylaw requires officers serve only one year, she said.
The were about three dozen members of the hospital staff in attendance among a crowd of about 200 people, including members of the hospital’s senior staff, who took on more technical questions for Schepici.
Ebba Hierta, a West Tisbury resident, gave a shout-out to hospital employees who couldn’t be there because they are commuters. She said they paid a penalty during the recent ferry breakdowns because they couldn’t get to the Island.
“They stood out in rain, sleet, and snow,” Hierta said. “They got their pay docked. That’s not acceptable. That sacrifice should be recognized.”
Schepici, without addressing the pay issue, assured Hierta that every employee is important.
“I don’t care if you’re here for a day, for a year, or 40 years,” she said. “You’re our employees … Every employee is valued at our hospital.”
Schepici was also direct, telling Hierta that Martha’s Vineyard Hospital would never have abortion services because there’s not enough call for it. “Do we have enough volume to do it well? Do we have the resources to do it consistently and well?” she said. “It’s a scale and resources issue, and we don’t always have the resources to do that.”
With the help of Daniel Pesch, head of the hospital’s obstetrics and gynecological services, she said that women are provided counseling and referred to appropriate services off-Island. “In a challenging time, we provide excellent services,” Pesch said. “We won’t turn anyone away.”
In another direct moment later on, Schepici said the hospital doesn’t have enough volume to provide urgent care beyond the emergency room. She did say, however, that the addition of primary-care doctors and nurse practitioners should give patients quicker access to healthcare without going to the ER.
As for nurse practitioners, Schepici told the crowd she’s a big fan, often preferring to see hers instead of her primary-care physician. “She spends more time with me,” Schepici said. “Having a nurse practitioner isn’t instead of a doctor, it’s in addition to your doctor.”
Schepici wasn’t afraid to admit a mistake, telling a woman that the hospital let her down when it failed to offer her alternatives to opioids during the screening process for a colonoscopy. The woman was asked if she had an alcohol problem or if she felt safe at home, but was not asked about drugs.
“We obviously have to do more,” Schepici told the woman. “We need to make sure [our screening] is clearer.”
Dr. Pieter Pil, the hospital’s chief of staff, told the woman she should have been offered Propofol instead of fentanyl.
In answer to a question about the future of Windemere Nursing & Rehabilitation Facility, which the hospital runs, Schepici answered bluntly that no beds are going to be added and that the hospital needs the community’s help in finding an alternative to care for the Vineyard’s aging population.
“It’s an Island problem, not just my problem. It’s a community problem,” she said, getting some applause from the audience. “We’re going to, together as community, look at what we can do.”
But she was clear that the nursing home is a drain on the hospital’s bottom line. “Windemere is the past. It’s not the future of elder care,” she said. “We will not close Windemere until we have a plan moving forward.”
The hospital needs a strategic plan and a facilities plan, because despite a fairly new hospital building, the other facilities for outpatient services are lacking, Schepici said.
She understands the community is looking for transparency from her office, and in that vein provided a window into hospital finances. So far the hospital is $3 million off last year’s budget, in part because of the addition of nurse practitioners and a shift to more outpatient services, which are reimbursed at lower rates.
“We’re having our ups and downs,” she said of the budget. “Hopefully we’ll make up ground on volume. That’s always a blessing and curse.”
The work toward more openness is just beginning, with her new communications director, Katrina Delgadillo, looking to engage the community on social media platforms. “This is just the beginning. We hope to have more forums,” Schepici said. “The best dialogue is face-to-face. Let’s keep the dialogue going.”