WRHS extends obstetric privileges

By Kristen Tribe | Published Wednesday, July 31, 2013

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The board of directors for the Decatur Hospital Authority Monday night approved granting obstetric privileges at Wise Regional Health System to Family Practice physicians meeting certain requirements.

The decision came at the recommendation of the Medical Executive Committee (MEC) after four months of discussions and most recently, a closer examination of the WRHS policy by an OB Advisory Committee.

Immediately following that vote, the board granted obstetrical privileges to Dr. Jeff Alling, Dr. Brad Faglie and Dr. Shawn White.

Dr. Jason Schuh, WRHS chief of staff, said the decision will improve the level of care for the community as a whole.

“We want to raise (the level of care) for all the patients in the community,” he said. “We want those patients delivered here at this hospital, patients that live in Wise County, that we go to Wal-Mart with and church with, delivered here instead of at Jacksboro.

“We can take better care of those patients here, regardless of who they choose as their primary delivering their baby,” he said.

Since 2009, WRHS had allowed only OB/GYNs to deliver babies.

Family Practice doctors Alling, Faglie and White, along with Dr. Lara Pierce, first sought OB privileges at WRHS in March when the hospital was in the process of acquiring the former North Texas Community Hospital (NTCH) out of bankruptcy.

The Bridgeport hospital had allowed Family Practice doctors to handle labor and delivery since it opened, which is where these doctors delivered babies in recent years. It was central to their practice.

Wise Regional Marketing Director Shannon Puphal said the original request was for an exception to the privileging standards for those four doctors. In June she told the Messenger that the board “did not feel that exceptions were appropriate, based on legal input.”

She said this is the first time the board has received a recommendation to actually change the policy for obstetric privileging, making it open to all family physicians.

To qualify, family practice doctors must be board certified or board eligible and have performed 100 vaginal deliveries and 50 C-sections as the primary physician.

Privileges will be renewed every two years, and to maintain those privileges, a Family Practice physician must have been the primary doctor for at least 40 deliveries in the previous 24-month period with at least 10 C-sections.

Board member Mark Duncum asked Schuh if the policy change would affect the quality of obstetric service at Wise Regional.

“It will depend a lot on a very intensive controlled guidance to them with the goal of collaboration, which can raise the standard of care with the involvement of OBs in educating their department,” said Schuh, who is an anesthesiologist.

“We see that even in my own profession when we have CRNAs (Certified Registered Nurse Anesthetists) come here. It raises our standard when we’re teaching … when questions are asked of us and we’re educating those that are part of our department.”

Since March, Alling, Faglie and White had been delivering their patients elsewhere or their patients had transferred to an OB/GYN specialist on staff. Now they will be able to care for their patients all the way through maternity, labor and delivery.

They will see patients at their various office locations, but all deliveries will be at WRHS in Decatur.

The Messenger was not able to obtain a comment from Alling, Faglie or White by press time Tuesday.

UPDATE —  Dr. Brad Faglie spoke with the Messenger Tuesday evening, and he said that he, Dr. Jeff Alling and Dr. Shawn White, who all now have obstetric privileges at Wise Regional Health System, were obviously happy with the change in policy. “I never thought that it wouldn’t happen,” said Faglie. “I just didn’t know how long we were going to have to go down this road.” He said the most important aspect of the change is that patients have a choice once again. “We went from 10 delivering physicians to three, and it really left a hole in patient care over the last several months. … We’re qualified doctors who can provide a service and the patients, because of some hospital policy, were unable to choose their own physician for that.” Faglie said he thinks everyone can move forward positively and that the family practitioners already have a good working relationship with the local OB/GYNs. “There is some doctor/hospital administration strife going on, and we’re all working together to iron that out.”

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