President's Page May 2004 Challenges remain in Dallas County health care Parkland board chair’s missteps led to resignations

by Warren E. Lichliter, MD 2004 DCMS President

As the year progresses, the challenges of health care in Dallas County remain. As physicians, we are accustomed to a fast process of disease evaluation, diagnosis, and treatment. As a surgeon, the adage “to cut is to cure” comes to mind. The political process, however, moves much more slowly, as is evident with the problems facing the county hospital system. Again, Parkland and its Board of Managers are the focus of attention.

Hardly a week passes without Dallas Morning News coverage of the latest issue in Parkland Hospital’s crisis. Numerous articles and letters to the editor highlighted the divisiveness of the Parkland board, especially the continued missteps of its former chairperson, Cynthia Comparin. Four members of the Parkland board, including Ms Comparin, abruptly resigned in early April, leaving the board without a quorum and unable to conduct business until at least one replacement was selected. This action was precipitated by the board’s March meeting, at which a large contingent representing Dallas Area Interfaith and West Dallas ministers simply and peacefully wanted to listen and be heard at the public board meeting. Although Ms Comparin may have had a point of order in not allowing the representatives into the room, in the public’s view, her decision clearly was the wrong one. Not allowing people directly affected by board decisions to be heard in a public meeting communicates no sensitivity to the present issues.

The groups attempting to attend that meeting have made Parkland’s future a priority. They and their constituents are experiencing increasing problems with access to care at Parkland. Dallas Area Interfaith and the West Dallas Ministerial Alliance represent more than 55 local churches and thousands of church members who are ready to mobilize, depending on the Parkland board’s budgetary decisions. DCMS has established communication with the DAI leaders to better unify the message being delivered to the Parkland board.

Ms Comparin’s repeated poor decisions compromised her ability to lead. Lauren McDonald, MD, who served as vice-chair of the Parkland board, has demonstrated the ability to make reasonable decisions and understands the need to work with the community in determining Parkland’s future. With Ms Comparin’s resignation, Dr McDonald will serve the role of interim chair well.

The problems of the Parkland budget and the hospital’s future are not unique. All over the country, community and county/city hospitals are struggling with the increased demand for services and a decrease in the money available to provide those services. The Legislature did balance the state budget, but that was accomplished partly on the backs of county officials trying to provide county services. The responsibility shift from the state to the county regarding Medicaid and CHIP funding illustrates the point. The money that is available to fund health care, roads, and other county functions comes from Dallas County taxpayers, and that means you.

It is in this context that Dallas County Judge Margaret Keliher must deal with the problems of Parkland. No one wants to see our tax dollars wasted. Clearly, any budget for Parkland must represent as efficient an organization as possible. The needs of the system must be determined, as opposed to the wants. Dallas should seek funding from surrounding counties, and additional funding from the state and the federal governments. Increasingly, the concept of regionalized funding for the delivery of care makes sense. After all, the patients treated at Parkland are not from Dallas County only, but from surrounding counties and even countries. We need to continue to deliver the best health care in Dallas, but we also must be cognizant of the tax burden of the residents of Dallas County. Dallas County taxpayers should not have to bear the entire cost of this region’s health care.

Judge Keliher and all the commissioners need our support in resolving these dilemmas, and we have offered our help. Several DCMS members have expressed willingness to serve on the Parkland Board of Managers, and we have provided their information to the county judge and commissioners court.

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