During 1994, the hospital board turned the management of the hospital over to Marian Health Services (now called Mercy.) Marian Health Services immediately turned their eyes to the clinic, and discussions were held regarding Marian providing management services to both the hospital and the clinic. The board's main objective in retaining Marian was the recruitment of physicians. The only way Marian would do this was if Marian controlled the clinic. I was then and remain– adamantly opposed to the outside control of medical clinics. I was seen as an impediment to recruiting physicians. In fact, according to Mr. George Rehder, board president, I was the reason Hawarden could not recruit physicians.

   In 1995, Dr. Daggett suffered a heart attack and couldn't work. On two occasions in 1995 I spend weeks as the only provider in town, working 24 hours a day, seven days a week. Throughout 1994 and 1995 I requested some relief from the on-call schedule. The board would not provide any support for me.

    In January 1996, after Jeanne Kleinhesselink resigned, I informed the Board that I could not work the current on-call schedule. I would continue to see my patients, but could not provide night and weekend coverage for the hospital, especially since the clinics in Akron, Beresford and even Sioux Center and LeMars did not have always provide local coverage on the weekends. At that point, I knew that Dr. Daggett and I could not continue providing 24 hours coverage for most of western Sioux and Plymouth county, Iowa and Union County South Dakota, and still maintain quality coverage to our patients. In February 1996 I was forced to accept a "courtesy staff" designation at the hospital. Once that was accomplished, the board informed me that the clinic building was only available to "active staff." I was evicted from a community owned clinic building so Marian Health Systems could assume management of the clinic without discussion or dissent.

   The community members that were members of that board are:

• George Rehder - President
• Ken Koch
• Mary Hendricks
• Darlene (Mic) Rummel
• Lorna Musliek
  (None of these people are on the hospital board today)

   I only wanted a break from the continuos on-call requirement and the board would not hear of it. However, at the same time they were evicting me for not taking unlimited on-call status, they agreed to limit Dr. Daggett to only one weekend a month and two week nights a week. This after they would not even discuss it with me.

   I thought long and hard about my options. The simple answer was to leave; to find a place I could work in peace and where I was appreciated. But then the support started. It became obvious that the only people that wanted me out of Hawarden were Marian Health; their employee, Mr. Katz; and the current hospital board. I could never find out why. I think Marian was afraid of the competition. In all the other communities they had invaded, Marian was never faced with competition. They were able to modify the manner and style of health care in a community because they were 'the only game in town.' Clearly, getting me out of town was the main motivation of the actions taken during this time. During a phone call, the hospital board president, George Rehder told my wife, Pam, that the goal of the board was to "...get Dr. Harvey out of Hawarden." I don't think getting rid of a doctor in rural Iowa can ever be in the best interests of the community, so it must have been for the benefit of Marian.

   My Staff and I decided to stay and fight. We felt citizens of Hawarden were just as entitled to quality, consistent, local health care as anyone else in Iowa. Why should I let Marian force me out of my home? We chose to build a clinic, near downtown next to the legal and insurance office that was under construction. It would take us six months to build a clinic and we wanted to remain in Hawarden during construction. I asked the hospital board for permission to remain in town while the building was constructed. The board would not consider that option, even after patients and the community rallied to my support.

   During March, 1996 the community started a petition drive to allow me to stay in the clinic until the building that became HFMC was completed, about six months. The petition drive was spearheaded by Joi and Marv Ebel and they have my sincere thanks. The petition contained over 1500 signatures, with over half from Hawarden residents. The board completely ignored the petition and stood by the eviction. Considering the ultimate motive was to get me out of town and assure Marian complete control of health care, it was the only thing they could do.

   We were evicted in May 1996. In the continuos battle to make my life as difficult as possible, Marian even forced us to contact all of our patients and get permission to copy their medical records. I don't know who decided the records belong to a building, not the physician. We hired people, rented copy machines and spent over $5,000 copying over a thousand charts. We moved the entire practice to our satellite office in Ireton.

   In April 1996 I hired Kim Brands, ARNP and shortly after I hired Ruth Siem, PA-C. A building made for one provider and one staff member was suddenly home to three providers and seven staff members. We were cramped, crowded, inefficient, and clumsy. But still the patients came. We certainly didn't have a good winter, but a lot of people braved the worst winter in years to drive the ten miles to continue their care with us.

   In early 1996 Marian, through their managed clinic in Sioux Center opened a satellite office in Ireton. Have you been to Ireton? It is a very nice town with about 700 people. We had been in Ireton since 1981. Why would Marian choose now to add another clinic in Ireton? Simple; to force us out of the area. If they could dilute my patient base enough to make it impossible to make a living, I would leave. Fortunately, people in Hawarden and Ireton are much more intelligent than Marian ever realized. We remained in Ireton and we were heading back to Hawarden.

   We finished the building and moved into Hawarden Family Medical Center on February 11, 1997. Now the hospital and Mercy (they changed the name in 1999) want to work together. Shortly after returning to Hawarden, the hospital administrator wanted to know if there was anything they could do to assist us!

Currently, in 1999, the hospital is trying to force us to accept night and weekend coverage. They want us to take call in exactly the same schedule Dr. Harvey offered in 1996. The schedule that was totally unacceptable then; one weekend a month and one night a week. The difference is now the hospital wants only the on-call provider to see patients nights and weekends. The Hawarden Family Medical Center provides 24 hour coverage for our patients and we are not willing to turn the care of our patients over to an unknown provider. We consider your health care a valued trust and will not do anything to risk that trust. We are not willing to accept an on-call schedule that compromises that philosophy. We maintain our independence. We will fight tooth and nail for the kind of medical care, the kind of doctor, the kind of clinic that adds to the benefits of small town life. Dragging big city medicine, with big city attitudes is not what we want in Hawarden.