Lincoln County Healthcare’s public meeting last week at the Opera House outlining the future of St. Andrews Hospital addressed some of the concerns of community members and left a few questions still unanswered.

It was a very well run meeting, although we’d have preferred that more attention be placed on the 21 questions addressed in the handout, with less time spent on a PowerPoint presentation.

There are still disagreements between Lincoln County Healthcare and the task force as to whether or not St Andrews has been/could be financially viable, and we don’t see the two sides coming together anytime soon.

There is also disappointment that no apparent attempt was made to make changes which would have put St. Andrews back on its feet a few years ago before it reached the point when it was deemed necessary to discontinue its status as a critical access hospital. There are those who still want Lincoln County Healthcare to give them the opportunity to prove the hospital can operate successfully.

It goes without saying that peninsula residents are devastated that they may no longer have the hospital they’ve depended on for 100 years. Trying to comprehend just what we will have left on the St. Andrews campus in the way of medical services once the changes are completed is still difficult as is understanding the reasons.

Most of those packed into the Opera House Wednesday night are fully aware that healthcare as we know it is changing almost daily and that the philosophy seems to be that bigger is better: bigger schools, bigger stores, bigger hospitals.

Critical access hospitals like St. Andrews were supposedly designed to meet the needs of small rural communities such as ours with limited population and thus less frequent needs for medical services. If a higher level of care was required, you went to a larger facility.

We could also take comfort in knowing that with today’s wonderful technology, a local family physician could communicate with specialists all over the world, share information and get advice almost instantly.

We’ve lost some of our physicians to Miles and other larger hospitals over the years because they want or need more patients and also are more comfortable having first-hand access to better equipment as well as to support staff.

When Lincoln County Healthcare outlined its plans to bolster services at St. Andrews, we couldn’t help but wonder why this hasn’t happened in recent months and years.

Why have all of the services moved to Miles rather than any of them being moved to St. Andrews? Lincoln County Healthcare maintains that patient volume declined before services here dwindled, but we have a hard time swallowing that argument.

During discussions about replacing St. Andrews’ emergency department with a reduced hours urgent care center, Lincoln County Healthcare praised the ER staff but claimed the numbers are too low to justify 24-hour coverage.

They also told the Opera House audience that if peninsula patients are picked up at their home or another location here for transportation to the hospital, they will not be taken to St. Andrews, but instead will go directly to Miles which has better facilities and staffing. Apparently, the only people using the urgent care center will be walk-ins.

While we understand that the long-term goal is to reduce the number of patients needing emergency treatment, and for good reason, we find it hard to rationalize why avoiding using St. Andrews urgent care for ambulance patients does much to help justify its very existence. How long before it closes completely?

LCH says figures show that the number of medical patients at St. Andrews is dropping, and we think LCH must accept some of the blame for that. It appears that precious few services or specialists have been headquartered here in recent years; they’ve all been located at Miles, even though Lincoln County Healthcare is supposed to be looking out for the well-being of bothhospitals.

As more and more doctors work out of Miles rather than St. Andrews, the logical place for their patients to undergo necessary tests is at Miles: one more step backwards for St. Andrews.

In fact, all of this discussion, or lack of it, on the future of our local hospital has prompted a number of local residents to switch to Miles doctors, further hurting St. Andrews.

Concern about the cost of the Boothbay Region Ambulance Service in future years remains high, and while it is admirable Lincoln County Healthcare is donating money to the towns this year to cut down on the tremendous expense they’ll face for training, staffing, equipment, etc., we have no guarantee that these donations will continue in the future, which means the burden will fall on taxpayers.

It was encouraging to hear that Lincoln County Healthcare is looking into the possibility of providing end of life beds here at St. Andrews so that families can be close to their loved ones. Everyone agrees this is of vital importance.

We hope Lincoln County Healthcare will schedule more public meetings in the weeks to come with much of the time devoted to questions and answers. The entire peninsula needs to have its concerns addressed and the forum Wednesday night was a step in the right direction.