ST. FRANCIS MED CENTER FLIER SHARED WITH ALL OUR READERS

This handout was distributed to employees of St. Francis Hospital in Cape Girardeau and to other members of the community. It suggests, according to its heading, that information contained in the flier wouldn't have been published if it had been made available to the Southeast Missourian.

In fact, most of the information cited by John E. Fidler, president and chief executive officer of the hospital, has been published in the Southeast Missourian over the past few months -- much of it attributed to Fidler.

At the same time, the newspaper has attempted to fulfill it responsibility for presenting all sides by publishing other views on the topics of health care costs, hospital mergers, the need for a second heart catheterization lab and emergency helicopter service -- again, attributed to informed sources.

In addition, there has been a healthy exchange of opinions in editorials, letters to the editor and Speak Out regarding these topics. In that same spirit of providing an open forum for the community, the Southeast Missourian is reprinting the hospital's flier in an attempt to keep readers informed.

At any time if St. Francis Hospital had expressed an interest in sharing the flier's information with the public, the Southeast Missourian would have gladly published it.

PERCEPTIONS VS. REALITY

A LOOK AT WHAT YOU'RE NOT READING IN THE NEWSPAPER

TO: The St. Francis Family

FROM: John E. Fidler, President/CEO

DATE: September 1, 1994

Saint Francis Medical Center has taken some "hits" in recent weeks inthe media. We've been criticized on several fronts such as the medical office building, our proposed second cath lab and our position on not merging with Southeast Missouri Hospital. I resent the way Saint Francis has been portrayed lately and I know many of you do, too.

The following are some "perceptions" the media has helped create along with the "reality" of each situation:

*Perception: Saint Francis isn't interested in controlling health care costs because they aren't willing to consider merging with Southeast Hospital.

*Reality: A merger is a course of action two hospitals sometimes pursue when one or both of them face financial difficulties. This is not the case in Cape Girardeau. Both Saint Francis and Southeast are financially solvent. Besides, there is little evidence to suggest that hosptial mergers control costs. Many combined facilities actually report cost increases following a merger.

*Perception: Antitrust laws have always been an obstacle to a merger of St. Francis and Southeast, but the government has "softened" its stand on anittrust issues.

*Reality: The Department of Justice and the Federal Trade Commission recently issued antitrust guidelines which, according to federal antitrust enforcers, do not represent a departure from traditional antitrust principles.

*Perception: The hospitals in Carbondale and Marion are considering a merger so we should be able to do it here as well.

*Reality: The Carbondale/Marion situation is different from ours in that Marion Memorial Hospital has fewer than 100 beds and an average inpatient census of around 40. These factors qualify the proposed Carbondale/Marion merger for a "antitrust safety zone" in which antitrust enforcers will not challenge a merger. Neither Saint Francis nor Southeast qualify for antitrust exemption. We do not plan to pursue a merger.

*Perception: It's inefficient and costly to the health care consumer for both Cape hospitals to operate air ambulance services.

*Reality: Both Air Evac at St. Francis and LifeBeat at Southeast are sufficiently busy so that one helicopter alone would be unabable to service the region's needs. As for the cost of operating the service, Saint Francis has no operational costs because we neither own the aircraft nor employ the Air Evac staff. Air Evac is an independent company with a base at St. Francis. In fact, Air Evac pays Saint Francis to operate its base here.

*Perception: The cardiac catherization program at Saint Francis is a duplication of services already offered by Southeast.

*Reality: Saint Francis established the region's first cardiac catheterization team in 1977 and the area's first cath lab in 1978. It was five years later that Southeast built the first of its cath labs. Because Southeast began its heart surgery program before Saint Francis there has been a public perception that Southeast's overall cardiology program was established first, but in terms of cardiac catheterization services, it was Southeast that duplicated Saint Francis.

*Perception: Operation of a second cardiac catherization laboratory would be an unnecessary expense.

*Reality: In terms of staff overtime and procedure delays, it's actually more expensive to have only one cath lab. the Missouri Health Facilities Review Committee has received a recommendation from its staff that Saint Francis be allowed to install a $1.76 million upgraded cath lab as long as we close our existing lab. According to the committee staff report, this would be more cost effective than operating two cath labs. We conted that the additional cost of maintaining the existing cath lab as a backup facility would be negligible when you factor in staff overtime and other costs currently associated with operation of only one cath lab.

*Perception: The public does not favor addition of a second cath lab at Saint Francis.

*Reality: The only organized opposition to the project has been voiced by the leadership of the Southeast Missouri Business Group on Health.

*Perception: If the Missouri Health Facilities Review Committee staff has recommended that Saint Francis operate only one cath lab, then a second lab must not be justified.

*Reality: Statistics used by the committee staff to make its recommendation were supplied by the Business Group on Health and understated both the population served by Saint Francis and the number of cardiac catherization procedures we perform. Had accurate figures been used, the Medical Center's second cath lab would have been justified according to the state's own guidelines.

*Perception: Construction of a medical office building on the Saint Francis grounds will increase patient costs at the Medical Center.

*Reality: We feel this project will either have no bearing on patient charges or will help lower them. We say this for two reasons: 1) the project would be financed by the physicians and padical practices that occupy the facility and 2) the physicians and practices in the building will have the cost-effective advantage of sharing overhead expenses, thereby reducing their operational costs.

I hope this fact sheet has helped answer some questions you may have about these pending issues. Should you have any other concerns or questions, please feel free to contact me. Thank you!

(signed) John E. Fidler