Perspectives on health care

March 20, 2014

From the desk of Swedish Health Services Chief Executive Anthony (Tony) A. Armada, FACHE

Dear Friends of Swedish,

During the four months since I started as Swedish's Chief Executive, I have had the opportunity to meet and speak with many of you and to learn your thoughts about Swedish, and share mine.

I am writing today to reach out to those of you I have not yet met in person. So, until I get that chance, I want to introduce myself and share some of my thoughts about this great health system.

As I am sure you know, this is a unique and very challenging time in the health care industry. The financial and economic pressures we face are significant, and both the environment we work in and the rules we must follow are changing rapidly.

Nevertheless, I am pleased to report that Swedish has never been stronger. This is true from both a financial perspective and in terms of our ability to care for the patients and families who come to us for care. We are, in 2014, able to serve more patients, deliver more babies, provide more charity care for more individuals and families and see more visitors in our neighborhood clinics than ever before.

Philanthropic support from many of you has been a key factor in this success, as have ongoing efforts-many begun before my arrival-to build a more efficient health system that will be increasingly able to provide the safest, highest-quality care at the most reasonable cost for all members of the communities we serve.

A key factor in developing the strength and efficiency that we will need to sustain Swedish in the years ahead has been our affiliation with Providence Health & Services, which began in early 2012. This event marked a major transition for Swedish, one that was not without controversy but one that, over time, has made us stronger. From the beginning, it was clearly understood and stated that Swedish would keep our separate name and visual brand after the affiliation was completed, and that we would remain a secular health care organization. These important requirements were negotiated and incorporated as legal commitments in the affiliation agreement. The bottom line is that Swedish continues to be secular and that it is still "Swedish." It is also still true that every dollar contributed to Swedish by its supporters remain at Swedish, supporting the delivery of health care in our communities.

Our affiliation with Providence has allowed us to combine many administrative functions and processes that promote efficiencies and reduce costs across each of our five campuses. Legal, human resources, supply chain, marketing and communications, and several other administrative departments, are now a part of a "shared services" group within the Swedish and Providence organizations. In this structure, Swedish maintains its separate identity and its own quality standards. The result is a much stronger organization that can focus Swedish cost efficiencies and savings on providing better care to more people in our communities.

Throughout the first two years of the Swedish-Providence affiliation, Swedish's leaders have heard questions and concerns from some members of our communities regarding access to care, particularly around beginning and end-of-life services and procedures. I would like to briefly discuss these concerns and some misperceptions we have heard.

First and foremost, it is important to understand that Swedish is not a Catholic organization and does not follow the Ethical and Religious Directives for Catholic Health Care Services (also called ERDs.) Prior to the affiliation with Providence, Swedish made a decision to follow clinical best practices by referring elective pregnancy terminations to outpatient settings with specialized resources needed to meet the needs of these patients. Full access to referrals by Swedish for elective pregnancy terminations is available for every patient seeking these services.

For complex pregnancies, clinicians at Swedish, as in the past, exercise their own best medical judgment to ensure safe, quality care for each patient. In addition, Swedish continues to offer a full range of birth control services, including tubal ligations and vasectomies, and there are no limitations on what a clinician can discuss with a patient.

We have also not changed our policies and practices for patients who face end-of-life issues. Swedish continues to fully respect and follow the wishes these patients indicate in their advance directives and living wills. There are no restrictions on what a physician can talk to a patient about, including all options under the "Death with Dignity" Act. Our policy on this act did not change as a result of the affiliation: Swedish independently chose, in 2009 (three years before any affiliation discussions), to not provide life-ending medications to patients. By law, all health care providers have the right to formally "opt out" of providing these services.

We know there is strong and organized opposition to affiliations between secular and faith-based organizations and that the Swedish-Providence affiliation has been and will continue to be described by some as having negative impacts on health care access in our communities. In fact, as I said above, the affiliation has made our organization stronger and better able to deliver on Swedish's longstanding mission of improving the health and well-being of each patient we serve.

That remains our mission, our focus and our promise to all who seek our care across our Western Washington communities.


Anthony A. Armada, FACHE
Chief Executive, Swedish Health Services