Hospital mulling a long-term solution for Aspen midwives

Three doctors will supervise a local practice of midwives at Aspen Valley Hospital for the next 30 days, an interim solution to a potential loss of service when the midwives’ physician left to establish his own practice.

Midwives at the Aspen Center for Women’s Health and their patients were without a physician after Dr. Kenton Bruice left the center on Aug. 1. Although Dr. Larry Menconi had been working with the midwives since Bruice’s departure, his temporary authorization to work in the hospital ended Monday.

The hospital board of trustees decided Monday night that Dr. Bruice, and doctors Melinda Nagle and Mallory Harling, both of All Valley Women’s Care, will supervise the midwives for 30 days.

Obtaining a new physician to work with at the hospital is a challenge for the midwives because Aspen Valley Hospital limits the number of specialized physicians that can operate. The policy is meant to protect quality care in the valley, said hospital board member John Jellinek.

“This is a very expensive town to live in, and [we need] to attract medical talent here that will stay, not part-time physicians or someone from New York who wants to practice here part time,” he said. “What the community needs to understand is that we don’t do this to benefit a bunch of doctors, or create a monopolistic situation. If you look at this logistically, we can’t have nine OB people in town. There aren’t enough babies, or [facilities].”

At the next meeting of the hospital board on Sept. 9, Jellinek said the board will discuss a long-term solution for the midwives. He emphasized that the hospital’s policy of limiting doctors is not set in stone, but must go through the staff credentials committee and the medical executive committee, and then take a recommendation to the trustees.

Linda Viera, one of the nurse-midwives in question and co-owner of Aspen Center for Women’s Health, said she is pleased with the trustees’ decision for supervision to be split among three doctors.

“Basically, it’s the patient care we’re concerned with, and we needed this coverage to take care of our patients,” she said. “Hopefully we’re looking forward to the board reversing the hold on the number of OB/GYNs in town, and we’ll have someone to help us out in our office again.”

Viera said the Center for Women’s Health has between 2,000 and 2,500 patients, and a number of pregnant patients at present. There’s definitely a demand for another doctor helping the midwives deliver babies in the valley, she said.

Dr. Bruice disputes a claim that he left the Aspen Center for Women’s Health without warning, saying he arrived at the office four years ago under the agreement that he would take over the business after three years. Bruice said he met with Viera and nurse-midwife/co-owner Teresa Hall in June and told them he was looking for office space for his own practice.

He said in contract negotiations the midwives presented him with salaries he felt were too high, and they turned down his offer for salaried positions.

“I think they want to continue to employ physicians because it’s more profitable for them,” he said. “But I don’t need to be an employee anymore.”

Viera said she, Hall and midwife-nurse Carole Moran had negotiated the contracts on and off for a year with Bruice and were in the process of trying to get mediation when Bruice gave them 24 hours’ notice of his departure. She said the salaried positions were “not really reasonable offers.”

“And based on his actions we didn’t feel we could work with him,” she said. “He was suddenly leaving the practice and leaving clients stranded.”

Bruice said he thought the negotiations were in good faith and is not “very happy” with the decision to work with the midwives on an interim basis until the trustees make a final decision.

“I still hope that there can be an agreement between them and us,” he said, adding he “totally understands” why the midwives want to hold on to their ownership of Aspen Center of Women’s Health. “The difference is, a midwife does need a physician to practice at the hospital.”

Jellinek said the two parties will have to work out the business dispute on their own.

[Naomi Havlen’s e-mail address is nhavlen@aspentimes.com]