Relations between Eastern Maine Medical Center and St. Joseph Hospital in Bangor have degraded in the last few years from a useful competition to a costly Cold War, with duplicative services, a lack of cooperation and increased pressure from administrators for physicians to choose sides. None of this has helped patient care. Certainly, it has driven up costs.

The community has limited access to the complex, difficult universe of health care administration, but must ask how it can end this expensive standoff and how it can protect the quality of care. Most important for EMMC, it must ask how trust in the administration can be regained in a divisive atmosphere. For St. Joseph, its administration must make sure it is not only listening to its advisory board but is willing to act on its recommendations.

Eastern Maine Medical Center and St. Joseph have battled for decades but, as one health-care provider observed this week, in earlier years their leaders could always talk to each other and they put patient care above all else, spurring each other to improve service. As detailed by reporter Michael Moore in Thursday’s edition, this has changed. The current antagonism between Eastern Maine’s CEO Norman Ledwin and St. Joseph’s CEO Sister Mary Norberta has resulted in duplicative services for osteoporosis and, potentially, cardiac catheterization, attempts by Eastern Maine Healthcare to create an HMO to exclude St. Joseph, a scaling down of expansion plans at St. Joe so that it would have cash reserves for its battle against EMMC, disagreements over ambulance service and a community health care clinic, plus numerous other instances of them making life difficult for each other when they could have made it easier. Even the proposal of a joint laundry service could not be worked out.

This lack of cooperation worsens the effect of the doctor shortage at EMMC and is another symptom of what concerns the physicians who have drafted a letter to EMH trustees asking, essentially, for better and more direct communication and more respect in decisions affecting patient care. How the trustees respond not only to the doctor’s individual concerns but to the larger issues that have created them will tell the public a lot about what kind of improvements to expect in Bangor’s hospital environment.

The fact that doctors believe it necessary to alert the public and contact the EMH board speaks loudly about just how far their trust in the administration and the administration’s procedures for resolving conflict has fallen. Under normal circumstances, the public would not hear about staffing shortages, recruitment assistance or weaknesses in the referral system. Now, after months of discussions and years of a culture change at EMMC, the public is hearing plenty, though the fear of retribution among health-care providers is real and no doubt limits the kind of information that has been presented recently.

Encouragingly this week, EMMC’s Medical Staff Executive Committee voted to urge trustees to convene a committee of doctors and trustees to examine the concerns of doctors. Trustees should accept the invitation and further support the committee’s intention to gather more input from the hospital’s medical staff. These are important steps in fully understanding the frustration that doctors have expressed in recent weeks not only about medical issues but about the lack of response from the administration.

The key for the EMH trustees is to focus on ensuring a high level of patient care through the long-term health of the hospital. This conflict is not about any one person or any one issue. It is about protecting a much-respected community institution, one that is needed more than ever and that must be able to respond to ever more difficult medical situations.

Bangor has been fortunate to have an excellent hospital in EMMC but its presence is not all luck. It exists – in fact, was founded – because the community understood and respected the need for such an institution. The role of the trustees is to support an administration that reflects these values and to listen closely when conflicts such as the current one warn of a perilous future.