Over the objections of two certified registered nurse anesthetists, the Ector County Hospital District Board of Directors approved an exclusive anesthesiology contract between Medical Center Hospital's ProCare 501 (a) and Permian Basin Clinical Services Tuesday evening.

James Horton and Cindy Kuykendall of West Texas Anesthesia, who've been practicing in the area for decades, said the contract would force them to join ProCare, a private, nonprofit corporation that hires doctors to work at Medical Center Hospital, by Dec. 31, 2009.

"Sometimes it's not always in the best interest of the patient," Horton said. "We're going from being entrepreneurs to having six bosses."

And while medical doctors who are ProCare anesthesiologists had contracts approved Tuesday for between $450,000 and $518,000, Kuykendall said the nurse anesthesiologists are not being offered the same pay.

"You see what their budget runs and you see what their deficit runs," she said.

But Dr. Tamarasha Williams, a ProCare anesthesiologist, said the program brings more consistency and better overall care to MCH.

"ProCare anesthesiology has been a great, great thing for Medical Center Hospital," she said.

Bill Webster, MCH chief executive officer, said that although all anesthesiologists currently in ProCare are medical doctors, the 501(a) is still willing to work with the West Texas group, while giving the anesthesiologists some independence.

"We would love to work with them," he said. "We are confident we can figure out a way to work with them, while meeting the spirit of the agreement."

Also Tuesday, a representative from a national health care ratings company patted Medical Center Hospital's orthopedics department on the back.

"This community hospital rocks," Lisa Esch of Golden, Colo.-based HealthGrades, told the board.

Overall orthopedic services at MCH ranked in the top 10 percent nationally three years in a row and placed seventh in Texas. It also took a clinical excellence award for finishing in the top 5 percent nationally in orthopedic surgery.

"We're very pleased to receive this recognition for orthopedics and spine surgery," Webster said. "We've always felt we have a really great group of orthopedic and spine surgeons. This just verifies that."

Esch said the awards are "very independent."

"This is not an award you can apply for," she said. "It is not achieved easily."

Board member Mary Thompson was happy with the news.

"This just makes you want to go out and break a leg," she said.

Charles Brown, the hospital's investment adviser, told the board, that with the current financial crisis, it was lucky it is involved with government-backed securities.

"Effectively, your entire portfolio is government guaranteed," he said. "We missed something in the ‘go-go' markets, but we don't have the losses either."

In other action, the board approved:

>> The purchase of property at 221 N. Lincoln Ave., which is appraised at $350,000.

>> A McKesson Clinical Analytics solution, which uses data to measure clinical performance, for $91,887.

>> A medical plan reinsurance renewal. The program with Short Benefit Services picks up payment on MCH's employer-sponsored health plan over $350,000, an increase over the previous amount of $300,000. MCH pays an annual premium of $298,745 on the service.

>> A contract with National Healthcare Review that will monitor reimbursement on the hospital's managed care contracts.

>> An interlocal agreement with Ward Memorial Hospital in Monahans to provide transfusion services.

>> A change in the board's next meeting to Dec. 9.

>> An agreement to sell property at 1308 Muskingum Ave. for $13,000, which is less than market value specified in a judgment of foreclosure against the property.

ProCare anesthesiology base employment contracts approved Tuesday:

>> Dr. Joseph Bryan: $450,000.

>> Dr. Marlys Munnell: $450,000

>> Dr. Gregory Theodore: $450,000.

>> Dr. Tamarasha Williams: $450,000.

>> Dr. Oscar Nunez: $450,000.

>> Dr. Kenneth Batch: $450,000.

>> Dr. Mark Johnson: $518,162 (contract service without benefits).

>> Dr. Prem Vindhya: $310,000 (part time).