Had Bud Barrow been the top executive at Our Lady of Lourdes years ago, the local health care environment would likely be quite different.

Barrow believes in physician partnerships. That philosophy wasn't in place for much of the last decade at Lafayette's two not-for-profit hospitals, which led to the creation of competing boutique hospitals like The Heart Hospital of Lafayette and Lafayette Surgical Specialty Hospital, neither of which is affiliated with any local hospitals. Both opened two years ago.

"We have failed our physicians," says Barrow, who joined Lourdes as president and CEO in March, moving over from Opelousas General Health System. "The great majority of hospital administrators have sought to protect their turf." In Barrow's mind, patients are physicians' customers, and physicians a hospital's customers ' his explanation for why partnerships should have been struck to keep local doctors from jumping ship and leaving hospitals in the cold. "We should have been at the forefront of that. We were not, and we paid a heavy price," he says.

And Barrow insists it's not Lourdes' battered bottom line that's given him 20/20 hindsight. He says boutique or specialty hospitals' success should serve as a "wakeup call" for other organizations like his. "Absolutely anything going forward will likely be [partnering] with physicians," he says.

Barrow's immediate predecessor, Bob Peebles, apparently shared his thinking. Peebles, who joined Lourdes after the specialty hospitals were well under way, made an unsuccessful attempt in early 2005 to strike a partnership with The Heart Hospital (after talks broke down between LGMC and the specialty hospital) but later in the year was able to secure Lourdes' first such partnership with Park Place Surgery Center, located in the Oil Center. In March 1999 the physician-owned center began operating and in mid-2003 added a 10-bed hospital. When he announced the two were joining forces, Peebles said ownership in Park Place allowed Lourdes to accomplish its goals without duplication of services or the expense of constructing a new facility.

It was also Peebles who got the ball rolling on the idea of a new site for Lourdes itself.

Barrow says Lourdes will be making announcements on this issue possibly as early as this fall. "If there's one thing Lourdes has been guilty of is to spend a lot of time talking. I think by the fall we'll be prepared to make significant announcements, statements of commitment." Those announcements, at least in part, will be in the form of a relocation of a significant portion of Lourdes services from its existing site at the corner of St. Landry and St. Mary streets. (Under Barrow's leadership, OGH completed a major phase of its $68 million capital improvement project.)

The administrator stopped short of saying Lourdes would abandon the 57-year-old facility altogether. "I'm not sure we'll ever disembark completely from here," Barrow says. Only a portion of the first and second floors of the existing seven-story hospital are part of the original facility, with the last major construction project ' which involved those floors ' completed in 1994. A $1.5 million ER renovation is under way, but most of Lourdes' construction in recent years has been adjacent the hospital.

Barrow says Lourdes' physical plant does not have specific structural or related problems that are driving an exodus. "Buildings wear out," he says. "We would both waste money and vacate true leadership to retrofit a 21st century hospital on the foundation of a 20th century hospital."

"Right now Lafayette has a 20th century model of health care, [and] 20th century models are doomed to fail. We're looking to build a 21st century model â?¦ [which means] all roads should not lead to one campus." Barrow says Lourdes is proactively studying how to best deliver health care in the future and is not merely responding to competition; he insists Lafayette's existing full-service hospitals are not prepared to embrace 21st century medicine.

Barrow would not release any specifics on what types of facilities fit this futuristic model, nor would he indicate precise geographic locations. He does, however, confirm the hospital's interest in the Boustany family land across from Women's & Children's on Ambassador Caffery Parkway, a 100-acre tract. "Specialty and focused-service facilities can be built in areas close to the consumer, often with quick access and convenience not often associated with large institutions," he says. Because of their small size, Barrow believes these facilities can more easily adapt to technological and market changes.

The administrator is quick to dispel speculation that Lourdes will be downsizing. "I don't think we're talking about building a smaller organization. I cannot envision any major services, or minor ones, that we intend to eliminate."

So just how does an institution that clearly is behind the competitive curve ' and admittedly losing business from heart procedures and other specialties that have gone to the boutiques ' manage such an expensive undertaking? It's simple, says Barrow. "[People] don't understand there's a significant difference between several years of losses and a strong balance sheet."

The 41-year-old not-for-profit Lafayette General Medical Center is still investing in the infrastructure of its aging Oil Center facility. Like Lourdes, LGMC has been through multiple expansions over the years and is now planning a $17 million "patient care" addition. Officials aren't releasing details just yet.

LGMC also missed opportunities to join forces with physicians but has since been more aggressive than Lourdes in pursuing various forms of hospital/physician partnerships on and off its main campus: In late 2004, it opened a surgical hospital/medical office building on Pinhook Road and last year set up an imaging center in the hospital's adjacent Burdin Riehl complex, in addition to announcing a plan to develop a neuroscience program within the main hospital.

A structural engineering assessment in early 2005 revealed the LGMC main facility's life expectancy to be 15 to 20 years. "The structural engineering assessment was undertaken as part of an updated master facility plan, [which] contemplates a significant renovation of the hospital," says Chief Operating Officer Donna Landry.

"As I understand it, 15-20 years is as good or almost as good a projection as such reports give. It's not that the building won't be good. It's that its structural integrity would likely need additional reinforcement, construction, etc. to add to it, materially change it beyond that," Landry continues. "Obviously buildings of much greater age still stand and are functional."

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