A letter to the editor in the May 23 edition of the Independent expressed concern about “the high turnover at Outer Cape Health Services” and vacancies in key positions there. While I cannot speak for the directors of OCHS, I can offer my own perspective on a problem that affects all of us.
While federal programs exist to attract medical professionals to work in rural areas and receive some education debt relief, anyone choosing to work here still has to contend with local housing costs and other limited infrastructure. As we consider the departure of health-care professionals early in their careers, we need to look beyond OCHS to our immediate community. Housing cost issues will continue to challenge all Outer Cape employers as veteran staff who moved here when housing was affordable, or at least attainable, retire, and organizations, both for-profit and nonprofit, consider succession planning and sustainability.
In July 2023, Dr. Robbie Goldstein, the newly appointed commissioner of the Mass. Dept. of Public Health, and Secretary of Health and Human Services Kate Walsh visited the offices of Helping Our Women, OCHS, and the AIDS Support Group of Cape Cod. Then they went on to meet with a larger group of health and human service agencies. For the first time, they both said, they were hearing that housing costs were affecting the ability of these organizations to operate here — that is, housing was not just a challenge but a barrier to basic business performance. At one meeting, a psychiatrist who had recently relocated to the Cape said she was having trouble finding a place to live even with a medical doctor’s income.
At the same meeting, I heard Dr. Damien Archer, OCHS’s new CEO, speak about this issue and his belief in this community being a place where we can and do find answers to challenging questions. His was a voice of practicality, reason, and optimism. I suggest that we grant Dr. Archer the benefit of a similarly optimistic attitude. Let us take a broader view of OCHS as part of our community: a critical component of what makes us local, sustainable, and desirable, like the beaches that beckon and hold us on our best days and our worst. In other words, I am asking that we consider OCHS in the context of our community, geography, and the shifting landscape of health care.
Health care in the U.S. today is fractured. For five and a half years, I have been executive director of Helping Our Women, a nonprofit that currently serves more than 300 women living on the Outer Cape with chronic or serious health conditions. Most of them use OCHS for primary or urgent care. We work with OCHS on multiple fronts and hear many different stories about people’s experiences there.
Have I made calls to OCHS to advocate for women who were receiving less than optimal care in the past five years? Yes, certainly. And have I had to make these same calls to large, prestigious Boston-area hospitals? You bet.
It’s easy to look at one agency and identify shortcomings. As someone who has served on numerous committees and studied organizational development and systems thinking, I am a strong advocate for viewing our successes and failures in the context of the complexity of the community in which these organizations operate. OCHS is undergoing a leadership transition, and the key to success in any such transition is not only the individuals in their roles but how the organization and the community in which the individuals are operating respond to, recognize, and receive these new people.
One key factor in a leadership transition is that many of the people who were there when you started are gone and there is a new team in place. This kind of change takes time. In response to the writer who expressed concern about departures at OCHS, I would simply say that it may be time for a shift in many of the departments, and that such a shift is needed to support the new leadership strategy laid out in OCHS’s 2024-2026 strategic plan, which can be found on its website.
I am excited that Dr. Archer was first hired as chief equity officer and was in place for succession to CEO. I see this as careful planning that has succeeded. I am equally excited about the arrival of a second health-care leader who is also a person of color: Dr. Marie Constant, chief population health officer & Provincetown medical director.
I am not saying don’t criticize OCHS. I am saying consider your criticism and get curious not only about the specific circumstances but about the larger context in which the circumstances are unfolding. Then ask what you can do to take action toward dialogue and engagement.
Gwynne Guzzeau is executive director of Helping Our Women.
