John Ferguson Guides Hospital Into the Future

By JULIA WELLS
Gazette Senior Writer

He's the quiet guy from New Jersey who kept his head down for nearly two years while the Martha's Vineyard Hospital lurched from one crisis to the next, unable to right itself in a stormy sea of bad faith and poor community relations.

Now John Ferguson is the man at the helm, and he is determined to steer the Island's only hospital in a new direction.

"We have momentum right now and we're not slowing down, frankly," Mr. Ferguson said in an interview with the Gazette this week.

Mr. Ferguson quietly took the gavel as chairman of the hospital board of trustees five months ago. At the time the hospital was mired in its latest controversy: A bitter conflict between Dr. Richard Koehler, a highly skilled surgeon, and Kevin Burchill, the hospital chief executive officer, had publicly boiled over into the Vineyard community. Dr. Koehler and Mr. Burchill both later left the hospital.

John Ferguson stuck around to pick up the pieces.

He was unknown, although he had been on the board for two years. But in Hackensack, N.J., Mr. Ferguson is far less obscure, especially in medical circles. Mr. Ferguson has been CEO of the Hackensack University Medical Center for 20 years. The medical center has won numerous awards for quality of care.

Now, as chairman of the board of the Vineyard hospital, he wears a new hat, but he claims no privilege. "I don't need a title. It's just an opportunity to be able to really, honestly change something," he said, adding: "I know the way a board is supposed to work and the one thing that their role is not is to get involved in operations. . . . Their role is to select the right CEO and to help that person," he said.

But behind the quiet demeanor lies a visibly tough determination to fix the problems at the hospital. Mr. Ferguson admits it won't be easy. A recent strategic planning summary found that if the hospital continues on its present course with no change, it will run out of money in eight years. The study outlined the need to rebuild both the hospital endowment and the hospital building.

He said change is under way.

A month ago trustees named former hospital chief financial officer Tim Walsh as the new CEO.

Last week trustees agreed to launch a fund-raising feasibility study, using the New York consultant Daniel P. Butler, to gauge the possibilities for a major capital project to build a new hospital. The board is also putting out a request for proposals (RFP) for a hospital master plan. "We need to look at the whole institution, 10 years out," Mr. Ferguson said. He said the fund-raising feasibility study will be complete in about three months.

A detailed review of every department is also under way at the hospital. "This is a little bit of the tough part. You have to look at every single department and evaluate whether it is needed," he said. "It's really not about the physicians, it's not about the hospital and it's not about the board. It's about what the community needs," he added, noting that orthopedics and psychiatry have already been targeted as areas for expansion.

He said there is a new working atmosphere at the hospital.

"People were spending a lot of time at the hospital fighting each other. It was always battles. And the board was too involved. There are good feelings now about the hospital moving ahead," he said.

"You need the right physicians, you need the right programs and you need the right feeling. If the atmosphere is good the volume will pick up because people will want to use the hospital. Now we are trying to create an atmosphere where people believe we can build this institution into a first-class rural hospital. Feeling good is a big deal. But it's going to take a little time."

Mr. Ferguson has also pledged to change the closed atmosphere that has prevailed at the hospital in the last two years. "That's the one thing I noticed. It was like a closed shop. A mystery. We are now totally, 100 per cent open. Even when there is bad news - nobody's perfect. Why shouldn't the community know every single thing - it's their hospital," he said.

Board changes have also begun. Last week Charles Harff, the vice chairman of the board who presided over much controversy, including a series of questionable hospital financial commitments and the mass resignation of seven trustees two years ago, announced his own resignation.

Mr. Ferguson had no comment on Mr. Harff's resignation. But he did say that more board change is imminent. "We're taking a real good internal look at the entire board structure. There will be changes, and pretty soon you will see some new members come on the board," he said.

Dr. Timothy Guiney, a longtime Vineyard summer resident and cardiologist who practices at Massachusetts General Hospital and holds office hours at the Vineyard hospital, was appointed to the board last week.

Mr. Ferguson has been coming to the Vineyard for 22 years. He and his wife, Jean, bought a home in Dodger's Hole some years back, and more recently built a home in Deep Bottom Cove in West Tisbury. He is here for about half the summer, although they come at all times of the year. "I have to keep the day job," he said with a small smile. The Fergusons have two grown sons who work in New York city and a daughter who will be a senior at Boston College this year.

Mr. Ferguson returned to the subject of volume.

I am convinced that with the proper changes and the proper physicians in place the volume will go up. This is a volume business. Increase the volume, and before you know it, you have a success story," he said. He said the hospital has already documented large numbers of people who are going to the Cape for services they could receive at the Vineyard hospital.

"The volume is there, and the staff at the hospital is really very good. But the building is a dump. They have to go around with buckets when it rains," he said.

He said part of the master plan will necessarily focus on some kind of staff housing, so the hospital can eliminate the use of expensive travelers as staff. Mr. Ferguson said travelers cost the hospital about two and a half times more than ordinary salaries.

He said he is unconcerned about the loss this year of the $500,000 in community tax money that was funneled into the hospital. The experimental project to use tax money to add to the hospital coffers fell apart when there was disagreement among the six Vineyard towns about how the money should be spent. Last year, the first and only year that the tax plan was carried out, the money was ostensibly used to defray the cost of services in the emergency room.

Mr. Ferguson's assessment of the tax muddle was blunt.

"The fact is that without the $500,000 the ER is not going to close," he said, adding: "If you ask me, the money should be used for all the free care we give." He said free care at the hospital accounts for about 20 per cent of the annual $24 million budget. He said the number is high by almost any standard. "In New Jersey our average is about nine per cent. And I believe the national average is about eight or nine per cent," he said.

Mr. Ferguson has brought his own style to board meetings. The board now meets every other month, with special meetings as needed. He said the three, four and five-hour board meetings that marked the recent past are also destined to become history.

"I run a hospital in New Jersey with an operating budget of $800 million, and we have 40-minute board meetings," he said.

Mr. Ferguson was sanguine about the future of Windemere, the Vineyard's only nursing home that shares the same campus as the hospital. Windemere has struggled to overcome its own financial problems since the day it opened in 1994. "Windemere is without a question part of the hospital. Things are better there financially, too - I think this year Windemere will end up losing only $200,000. But it is a different business entirely. I could not run a nursing home. It's two kinds of businesses as far as how you run them, but there are a lot of hospitals that have nursing homes. The way I see it, Windemere will stay, but everything will be looked at," he said.

He concluded: "It takes time. That's all I need is a little bit of time and a little bit of luck and the right people in place."