With Hospital Quality Seen as Paramount, Health Consultant Leaves Politics Behind

Matthew Hersh

When the Princeton Health Care Task Force appointed an independent consultant last month to offer an analysis of Princeton HealthCare System's (PHCS) recently released strategic plan, they did so hoping to bring an apolitical, unbiased perspective to a subject that has threatened to turn into a political firestorm.

The topic of the ultimate location of the University Medical Center at Princeton (UMCP) and other PHCS facilities has been the subject of talks with Princeton University, and has been included on the "Next Big Thing" list for Princeton Future, a community group that analyzes the impact and feasibility of area development. All of this suggests that whatever the hospital's final conclusions may be, they are sure to have an impact on the community at large, not only through health-providing services, but through changes in traffic circulation, new zoning for subsequent facilities if the hospital decides to vacate its current location at 253 Witherspoon Street, and through a potential increase in tax-generating rateables in the Borough. The hospital, a 501(c)(3), charitable organization, is tax exempt.

But Dr. Alan Sager, a professor at the Boston University School of Public Health, School of Medicine, and, most recently, the consultant appointed to review PHCS' strategic plan, says that he will generally steer clear of politics and approach the subject of the hospital's future with health care in mind. While he acknowledged the ramifications of such a facility either leaving or building upon its current complex, he said he was specifically brought in to weigh the options that the hospital has given to him.

"I expect local and elected officials would be in a far better position than I am to determine popular demand," Mr. Sager said Friday. Speaking from his office in Boston, he added that in his capacity, "polling" members of the community would offer "inherently unreliable" results as far as determining the majority opinion.

"My role tends to involve more technical matters, and finding the advantages and constraints of a comprehensive, multi-year renewal process on-site." Asserting that non-technical matters would be left for the community to decide, he said: "I'm not a politician."

The consultant did say, however, that this current administration, under the direction of Barry Rabner, PHCS president and CEO, has sought to improve the hospital's relationship with the community, one that had been deteriorating under previous administrations.

"The hospital's relations with the neighbors had been rubbed wrong over the years, where the hospital was engaged in rancorous and contentious encounters with the neighbors and local government, so certainly the neighbors have remained at a high state of vigilance," he said.

Prof. Sager was brought in using $5,000 in grant monies from the Robert Wood Johnson Foundation. He will base his ultimate findings on the information put forth in PHCS' strategic plan and information acquired from a public forum to take place at Township Hall on September 29.

He will also use his extensive knowledge of urban hospitals in determining what is best for PHCS. Prof. Sager is a principal in Massachusetts's Access and Affordability Monitoring Project, which was founded to look at problems related to health care access and cost and aims to establish more effective ways to provide and finance health care.

Prof. Sager is now in the process of updating a study involving 1,200 hospitals in 52 cities over the past 70 years. The study looks at threats to urban hospitals, namely in neighborhoods with large minority demographics.

PHCS has not indicated that it will close, but has simply cited the need to be more competitive with area hospitals like Robert Wood Johnson University Hospital in New Brunswick. PHCS has expressed concern that UMCP could lose physicians and patients to these other area hospitals. "If the hospital's survival is essential, it needs to make good decisions about how good it can be in today's health care market," Prof. Sager said.

Princeton HealthCare System's strategic plan attached a $230 million pricetag to building a new campus, with about $15 million required to attain the land needed to accommodate such facilities. PHCS estimates a cost of $180 to $190 million to expand its current facilities on Witherspoon Street.

After its September 29 meeting, the Princeton Health Care Task Force will hold a mid-October public forum on expanded or alternative uses of the current hospital site.