Bennington marks local hospital's centennial
BENNINGTON — Over the past century, Bennington's hospital has enjoyed successes and endured some harsh trials, but it thrives today because of timely, progressive leadership and strong community support.
That's the assessment of Tyler Resch, who has written two books on what opened in 1918 as the Putnam Memorial Hospital and is known today as Southwestern Vermont Medical Center. His second volume was released this week.
"I think the message that comes across is the extent to which a hospital takes a role in the community, in the health of the community," said Resch, the research librarian at the Bennington Museum.
"The story that it tells is of some great interest," he said. "I mean, there have been some ups and downs, as you might imagine and see in these chapters."
His new book, "A Century of Caring," covers the history of the institution from the founding to the present era as SVMC, while his "Deed of Gift: The Putnam Hospital Story," coincided with the 75th anniversary celebration and was published in 1991.
In an interview, Resch said a key factor in the hospital's survival while others in the region have closed was the support of the original benefactors — Henry W. Putnam and Henry W. Putnam Jr. — and those in the community who later stepped forward as board members to stabilize the organization when necessary.
Another key, he said, has been a remarkable line of strong and progressive --- sometimes aggressive --- hospital administrators.
They included the first, Mary D. Baker, a registered nurse in New York City who was recruited by Henry Putnam Jr., and Dr. Francis Bean, who pushed during the 1940s for new facilities, advanced equipment and specialists before resigning in frustration when the trustees failed to provide enough funding.
But Bean "set the tone" for hospital leadership eras that followed, Resch said, even though he couldn't convince the trustees to fund his plans during the lean financial period that followed the death of the younger Putnam in 1938, and during the Great Depression and World War II.
In his final report to the board in 1948, Bean said: "We don't expect to see a second Mayo Clinic, but in a modest way we believe the hospital can do much more with its resources to serve this community than it is now doing."
After what Resch termed a period of difficult finances and relative stagnation through the 1950s, Robert D. Stout arrived as the administrator in 1961 and was joined by a dynamic board chairman, retired Union Carbide chemist Joseph G. Davidson. They oversaw a second period of growth for the institution in terms of buildings and medical services, and the transformation of Putnam Hospital into a regional medical facility.
Harvey M. Yorke was the next notable CEO, continuing an aggressive approach to regionwide care and advanced medical facilities and treatments, Resch said. However, Yorke's tenure ended abruptly after nearly 18 years, when he and other top administrators were dismissed during the recession in 2009, amid surging operating deficits for the organization.
As CEO, Yorke "was very strong for education," Resch said, and he "wanted to make this the healthiest community in the nation."
Yorke also oversaw some major new construction on the SVMC campus off Dewey Street.
And today, Resch said, CEO Thomas Dee has overseen expansion of satellite facilities in Pownal, the Northshire, Hoosick Falls, N.Y., and the Deerfield Valley, as well as far-reaching partnership agreements and collaborations with Dartmouth-Hitchcock Medical Center --- bringing more advanced medical services, equipment, personnel and training to Bennington.
"Think I'd put a lot of stock in the CEOs," Resch said. "I knew Bob Stout personally, and he was certainly pushing all along; and Harvey was very outspoken and aggressive, and certainly Tom Dee is. I think it is a function of the executive pushing."
The first half-century
The Putnam Memorial Hospital opened its doors on June 11, 1918, three years after its proponent and benefactor, Henry W. Putnam, died, and nearly 20 years after he had retired and settled in San Diego.
But Henry W. Putnam Jr., called "Will," carried on his father's wishes, providing $100,000 for construction of the hospital and $30,000 for equipment.
In his new book, Resch cites the "loyalty and persistence" of the younger Putnam in continuing to fund new buildings and wing additions to the hospital and covering annual operating deficits until his death in 1937 — when his estate added $3 million to the endowment.
Even today, the Putnam legacy in Bennington remains strong, as the proposed redevelopment of the Hotel Putnam and the Old Courthouse building at the Four Corners, both built by Henry Sr., are at the heart of a major project local investors (including Southwestern Vermont Health Care) hope will revitalize the downtown.
The elder Putnam, who made a fortune through his innovative hardware products, including his patented "Lightning Jar" bottles and caps, first came to Bennington in 1864.
His Horatio Alger-like career, Resch said, began during the 1848-55 California Gold Rush, when he began selling bottled drinking water to the thousands who arrived to seek their fortune after the discovery of gold.
Although he lived elsewhere for many years, and his national businesses were headquartered in New York City, the elder Putnam built a large home in town and maintained some manufacturing operations here. At one time, he was listed as the largest property owner in town and he served as a selectman after first arriving.
Putnam also spearheaded the Bennington Water Works, which formed the basis for the current water system, and which he donated to the town in 1912 with the proviso that some of the income from the system support health care for the indigent.
He constructed the Bennington Opera House across the Four Corners intersection from the hotel, but it burned in 1958. His imposing former home off North Street was later used by St. Joseph Business College, which evolved into Southern Vermont College. The building was torn down during the mid-1960s.
Henry Jr. lived for many years in New York City but made numerous visits to Bennington, often staying in modest quarters in the nurse's residence building on the Putnam campus. Sometimes the lifelong bachelor met a lady friend here. She was from Connecticut and they usually traveled to Bennington separately, Resch writes.
He says in his 1991 book that Putnam Hospital opened during a period of rapid transition nationally for health care and particularly for medical institutions. There were approximately 178 hospital institutions listed in 1873, but by 1909 that number had soared to 4,359.
Mary Baker was selected as superintendent two years before the hospital opened. During her 25 years at the helm, she oversaw five building expansions and struggled with financial difficulties and a disastrous fire in 1932 that closed the hospital for a year.
Baker managed the hospital and the nurses, who lived on the campus and worked long hours, with famously close attention to every aspect of the institution. That included an on-going struggle to pay for the many "charity" cases as the Great Depression wore on and the flower plantings and a vegetable garden she tended on the hospital grounds.
Baker also made it a point to visit every patient every day, totaling up an estimated 26,612 personal visits from 1918 through 1943, Resch writes.
A new era of growth
Robert Stout, who took over during the first years of the Kennedy administration and the idealism that inspired, ushered in what was considered "a golden era for hospital administration," both in terms of physical expansion and equipment but also in rapid improvements in the quality and training of the hospital staff, Resch writes, adding that many young physicians from elsewhere were at the time attracted and lured to the Vermont lifestyle.
Stout and Davidson worked together for more than a decade, with the latter, the owner of Mount Equinox and builder of the Skyline Drive, adding another dimension of dynamic leadership as board chairman.
Among the numerous building projects cited in the book during the expansion years 1974-91 were an 85,000-square-foot West Wing project that doubled the size of Putnam Hospital; the first phase of a medical offices building adjacent the hospital, which opened in 1977; a second unit of the medical building, opened in 1987; an 800-foot drive from the facility to Monument Avenue Extension, providing an alternative to the traditional Dewey Street campus entrance; the 100-bed Weston Hadden Convalescent Center, which opened in 1985 and was funded through a $2 million bequest from the late resident for whom it was named; a 50-bed addition to the facility in 1993, and development of the SVHC Regional Cancer Center.
During his years with the institution, Stout also was very active in the community, including helping to establish the Bennington Rescue Squad and the United Way of Bennington County.
Nursing program director Julia Bolton, who began at the facility in the late 1980s, was another leader credited with having a strong influence. She began putting into place structural and administrative changes in the nursing department that helped the hospital win its first Magnet status honor, one of only 47 nationally so recognized.
Bolton also served as interim president and helped establish the QUEST awards (Quality, Empathy, Stewardship and Teamwork) to help identify the institution's core values and recognize those in all departments that exemplified those values.
The next long-serving CEO, Harvey Yorke, incorporated that approach in his concept of Mission and Values, according to the book.
Yorke began in late 1991, and "by 1993 his vision had expanded into a grand — some would say grandiose — ambition that Dr. Bean and Dr. Davidson surely would have applauded: 'To make our communities the healthiest in the nation,"' Resch writes.
He formed what was called The Vision, which he continued to develop as a concept for the health care organization. It included universal access to a continuum of care; access to the system through a primary care provider; a centralized computer system to share information and measure outcomes; a network operated at the local level; financial accountability to members; and incentives and education to promote a healthy lifestyle.
In 1994, Yorke also spoke of a new emphasis on keeping people well rather than merely treating illness.
Among changes he instituted were to add a hospitalist program that added hospital-employed physicians, which reduced the strain on outside doctors to monitor patients and greatly improved communications between doctors and nurses — which in turn helped reduce medical errors and nursing staff turnover and improve overall quality of care.
A four-story addition completed in 1996, housed a surgical suite, maternal-child health department, an ambulatory care center, cardiology testing unit and other services.
Yorke also twice proposed assisted-living facilities to both reduce the need for expensive nursing home care and meet a growing demand for such centers as baby boomers began to retire. However, both projects eventually failed, the second after being denied permits amid neighborhood opposition and costing the hospital $1 million in preliminary project costs.
Quality of care statistics showed improvement during this period, such as in a 1999 top ranking in a Press Ganey Associates Inc. survey of 454 hospitals nationwide in patient satisfaction, shortest waiting times and best communication with patients and families.
In 2000, the corporate entities of the entire health care organization were reformed as Southwestern Vermont Health Care, which includes SVMC. The medical center had received its current name in 1984.
The financial crisis that led to the ouster of Yorke and other top administrators in 2009 occurred during the Great Recession amid changes and new financial complexities in health care that led to deficits at a number of hospitals, including the former North Adams (Mass.) Regional Hospital.
There were discussions of a formal liaison with another institution, but numerous questions were raised and an affiliation with a larger hospital — Dartmouth-Hitchcock — would not become a reality for several years, after Thomas Dee had succeeded Yorke as CEO.
First, however, Dr. Mark Novotny, the chief medical officer then serving as interim CEO, had to oversee a reduction in staff costs and take other steps to slash the deficit. A national search for a new CEO was launched, and Dee was chosen from among 300 candidates and six finalists.
The new administrator pursued several initiatives that helped stabilize the institution's finances, including exploring an affiliation with another institution, establishing a hospital foundation board separate from the board of trustees to concentrate on fundraising, and expanding and reviving the SVHC board, Resch said.
In 2012, SVMC physicians became part of the Dartmouth-Hitchcock Putnam Physicians group under an agreement with the Hanover, N.H.-based Dartmouth-Hitchcock health care organization.
Other affiliation agreements with the larger institution followed, involving collaboration on several areas of medical care and shared expertise and technology.
SVHC's reach also continued to expand through the county into other states, including expansion of a clinic in Wilmington, a new Pownal primary care office, enhanced facilities in the Northshire, and in a satellite clinic in Hoosick Falls, N.Y.
SVHC also now has a 2020 plan, which envisions partnerships and collaborations with organizations such as United Counseling Service and further affiliations with Dartmouth-Hitchcock.
Dee has said major investments in the health care system here are under consideration that would extend beyond 2020, including expanded or renovated facilities and technical improvements, including remote video consultation with physicians at Dartmouth-Hitchcock Medical Center and elsewhere.
Copies of the newly released book, "A Century of Caring - From Hospital to Heath System: The story of Southwestern Vermont Health Care," are available for $50 at the Bennington Museum and at the medical center gift shop. It was published by SVHC.
Jim Therrien writes for New England Newspapers in Southern Vermont and VTDigger.org. Email: firstname.lastname@example.org. @BB_therrien on Twitter.
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