News that UnityPoint Health – Marshalltown would be eliminating its intensive care unit was another indicator of the cyclical issues the local hospital has faced.

Simplistically, when businesses don’t make money, they can’t sustain all of their resources and when consumers believe an organization doesn’t have adequate resources, they do business elsewhere. The health care issues in Marshalltown meet that mold, but are also much more complex.

In order to overcome the complex mutual challenges, community members and UnityPoint must find common ground.

Whose to blame for these issues is not black and white. UnityPoint took over the hospital from bankruptcy. It would be hardly fair to point at the organization’s leaders and say it is entirely their fault cuts had to be made. And even with those cuts, the organization still posted a $7 million loss year-to-date, according to its announcement earlier this month.

Yet, it would be unfair to blame the community members. When your life and wellbeing is on the line, you want to seek services you trust. A formerly bankrupt hospital does not embolden people to seek care locally. Because of this, patients are choosing to seek services outside of Marshalltown.

Rural and mid-sized communities across the state face challenges with maintaining health care services with limited numbers of patients. When community members seek health care outside of Marshalltown, the hospital doesn’t have enough money to keep underutilized resources around.

Marshalltown is a large enough community to need a local hospital, but it is also a small enough community that trust and word of mouth matters. There is a reason communities our size have popular restaurants and businesses — because customers know what type of service to expect and sometimes more importantly who will be providing the service. The many changes in the staff and the services at the hospital do not establish that trust.

From a business perspective, it makes sense to eliminate a unit such as the ICU that only sees one patient per day on average. But many community members see it as yet another resource their local hospital is losing after the cath lab and other eliminations have occurred since UnityPoint took control.

Data from a 2012 Market Insights survey showed that 87 percent of consumers believe reputation is important when seeking a hospital. Because hospital reputation is so important, quality of care only matters if patients have enough faith in the hospital to seek out the care in the first place.

UnityPoint needs patients. Community members need stability. How both organizations get what they need is the challenge that we all must work to solve. A trusted hospital is essential to economic vitality.

UnityPoint is working with a consultant to examine why people are seeking services elsewhere to help solve the problem. This is a great start, but this issue really requires support from the entire community.

As advocates for public forum, the Times-Republican encourages community members to participate in the conversation and share ideas for moving forward.