WATERVILLE -- Physician Sheridan Oldham stood before about 300 doctors, politicians, community leaders and residents in March 2004 to rally support for keeping MaineGeneral Medical Center in the city.

At the time MaineGeneral was talking consolidation and had made public a proposal to build a regional hospital somewhere between Waterville and Augusta.

Oldham and the Save Our Hospital campaign she led ultimately prevailed.

MaineGeneral scrapped its regional hospital ambitions and renewed its commitment to both Waterville and Augusta, pledging to maintain a community hospital in both cities with at least limited inpatient services at each location.

But this week MaineGeneral revived its consolidated hospital plan.

And this time Chief Executive Officer Scott Bullock named the location for the proposed regional hospital: Augusta.

He also announced that Waterville would cease to provide inpatient services at its two facilities -- Thayer and Seton units.

Oldham, now retired, sees the plan as a betrayal of trust.

"I'm horribly disappointed," she said. "I think there were promises and assurances made that were not kept, and it's awful."

MaineGeneral physician Lisa Marrache, a Waterville resident, said the news disappointed her as well.

But for Marrache, who also is Waterville's state senator, the issue is the impact on the economic health of the city.

Marrache said she accepts the rationale behind the consolidation.

"We are not going to be able to stay in two places," she said. "Financially I understand that argument. I'm saddened that this will hurt this economy with the departure (of a full-services hospital)."

David Landry, an anesthesiologist at MaineGeneral, said the MaineGeneral medical staff understands that dynamics surrounding hospital care have changed dramatically in recent years.

The traditional models, he said, no longer apply.

"It has been a difficult realization," he said, "but I think if you poll the medical staff, I think most of us have to come to the realization that the mom and pop hospitals are not going to be where the majority of care will happen in the future."

Staffing subspecialty areas of health care is among the biggest issues, Landry said.

Marrache agrees.

She said, for example, that Waterville used to have five cardiologists. That number is now down to one, she said.

MaineGeneral, moreover, lost its only neurologist when Marvin Eisengart retired this year, Marrache said.

Even the Alfond cancer center in Augusta, a regional medical facility, struggles in regard to staffing. Marrache said the center could use three more full-time oncologists.

Nevertheless, Landry said MaineGeneral's best hope for recruiting and retaining specialists and primary-care physicians is to consolidate its operation.

By doing so, he said, medical staff can be bunched under one roof to minimize the patient burden placed on any individual doctor.

"If we want a vibrant, well staffed hospital," he said, "we have to get bigger, and I think the medical staff has come a long way to understanding what needs to be done."

Oldham does not dispute the subspecialist recruitment issue.

She said she understands that consolidation is necessary to deal effectively with that challenge. What bothers her, she said, is the location of the planned hospital.

"Why can't they build it here?" she said.

Oldham said with major hospitals in Portland, Lewiston and Bangor, the more logical site for a regional MaineGeneral Medical Center would be in Waterville.

Build in Augusta, she said, and you are moving farther away from a sizable portion of your current service area.

"I think it puts the folks in Somerset and Northern Kennebec counties who need subspecialty services at a disadvantage," she said, "and ultimately, I think, MaineGeneral will lose that market because of its decision."

Landry, however, sees it differently.

He said the Augusta site makes sense in terms of being more accessible to those traveling east and west -- Route 3 runs close by the proposed location.

Marrache pointed to Inland Hospital as the main reason MaineGeneral didn't choose Waterville.

"It would be hard to justify building a mega-hospital," she said, " in the same town where another hospital is located."

Landry said he realizes that many will debate the location decision and that heavy emotions are inevitable.

"I think people can argue the site for the next 10 years," he said, "but the reality is we need to begin now."

Landry is convinced, in fact, that the consolidation, despite its planned location in Augusta, will be beneficial to Waterville's economy.

A consolidated hospital will help MaineGeneral bring more specialists to the area and help to retain the current staff.

"I don't think it will have a big negative economic effect," he said of the proposed move to Augusta. "What would have a negative economic impact is an inability to recruit younger physicians and the erosion of what we have."

Colin Hickey -- 861-9205

chickey@centralmaine.com