The top executive of Forsyth Medical Center on Monday called Wake Forest Baptist Medical Center’s decision to start delivering babies “surprising and disappointing.”
Dr. Stephen Motew, who serves as president of Novant's greater Winston-Salem market, said the hospitals’ joint venture had held together for more than 41 years because it was “predicated that we are better together for the community ... on patient health, and we have done better as a result.”
Under the 1977 contractual agreement between the two hospitals, Wake Forest Baptist voluntarily stopped offering low-risk labor and delivery procedures on its main campus, instead focusing on high-risk pregnancies and deliveries.
In low-risk cases, Wake Forest Baptist obstetricians deliver babies at Forsyth.
Wake Forest Baptist said last week it planned to start delivering babies in late 2019, putting it in direct competition with Forsyth.
The last time the systems had a major public clash was in their efforts to open community hospitals four miles apart in the western part of the Triad — Novant in Clemmons and Wake Forest Baptist in Davie County.
That competition took on the look of a political campaign at times, complete with rallies, color-coded T-shirts and fliers sent to residents, from 2007 until a settlement was reached in December 2009.
Novant initially said last week that it had no comment on Baptist’s plans. Motew said Monday, though, he chose to speak in part “to inform the community and our patients that we will continue to provide the same level of high quality, high complexity, established and complete spectrum of care for mothers and babies.”
“It’s here at Forsyth, it will remain at Forsyth, and we’re very proud of this program for its long-standing commitment to the community.”
Forsyth had the second highest number of deliveries in North Carolina in 2017 at 6,423, of which about half were handled by Wake Forest Baptist doctors, according to Dr. Julie Ann Freischlag, chief executive of Wake Forest Baptist and its medical school dean.
By comparison, Wake Forest Baptist had 22 high-risk deliveries last year, whether identified for such care early in the pregnancy for the sake of the mother or baby’s health, or because complications occurred while the mother was giving birth. Wake Forest Baptist said it began focusing primarily on high-risk deliveries in 1974.
Both hospitals have neonatal intensive-care units.
Motew stressed that Forsyth is “very used to and experienced with competing and developing plans. Our ability to operationalize a response I am extremely confident of” between now and late 2019.
He also said Baptist’s plan could affect other collaborative efforts between the two hospital systems.
“These moves by Wake Forest Baptist have diverged from that vision, or so it seems,” Motew said.
He said Forsyth had plans in place for its future growth.
“We have contingency plans for this, like we do if the state decides to expand Medicaid, with some of the work done ahead of time.
“We are determined to compete and grow services at Forsyth Medical Center, especially in the category of women’s care and neo-natal care,” Motew said.
Freischlag told the Winston-Salem Journal on July 11 that Baptist officials had been discussing resuming traditional delivery services in recent years. She said her appointment as head official in May 2017 spurred renewed interest from employees on the subject.
She also said she isn’t anticipating any pushback on its attempt to resume deliveries, saying initially the discussion centered around offering birthing services to Baptist employees.
Freischlag then acknowledged the service would be available to all women in the region, particularly those who have a Wake Forest Baptist doctor as their obstetrician.
Freischlag said Monday in response to Motew’s comments that she hopes the systems will be able to continue most elements of the joint venture.
“Academic medical centers like ours often partner with more than one community health system in cities around the country to provide physician expertise,” she said.
“Our obstetricians, anesthesiologists and neo-natologists have worked alongside those employed by Novant and in private practice to manage and ensure the highest quality of care for moms and babies for the past 45 years.
“We believe an ongoing partnership is good for the community and with good precedent,” she said.
Freischlag said she spoke with Novant officials July 10 about Wake Forest Baptist’s birth center plans.
Motew said Freischlag brought up the decision at a dinner meeting that hospital officials conduct frequently to discuss multiple community health issues.
“It was an intentional conversation,” Motew said. “I can’t speak to what their motivation is, but the explanation is aligned to what the public has heard until now.
“It’s not uncommon (over the years of the agreement) for a new leader to question what it’s all about.”
Freischlag said Wake Forest Baptist believes “there are enough deliveries in the county annually to support two birthing centers.”
“Our physicians will continue their normal advising patterns with patients, with the ability to inform them they have another in-county choice for where to give birth,” Freischlag said.
Baptist would renovate two floors of its main hospital for the expanded birthing center. The project would include expanding and updating its neonatal ICU, which would have 51 private rooms, with two reserved for twins.
When asked if Forsyth is preparing to provide on-campus neo-natal and delivery services with just its personnel, Motew said “it’s too early in the process to understand what that’s going to look like.”
“There are multiple options we are exploring.”
Motew said the apparent breaking of the joint venture agreement could affect other collaborative efforts between the systems.
He cited as examples “the commitment to an educational mission, staffing from their side ... are considerations which makes this even more surprising and disappointing to us with the manner and the message that they revealed to us.”
The Forsyth-Wake Forest Baptist agreement led to a later agreement that allowed Wake Forest Baptist to operate the trauma center that covers Forsyth County and much of Northwest North Carolina.
When asked about whether Forsyth would re-establish a trauma center, Motew pointed to other complex services that Forsyth has added over the years.
“Advanced surgical treatment and trauma are services we would consider, but it is too early to share our plans at this time,” Motew said.