Three longtime doctors with Sylva Pediatrics will soon come under the wing of Mission Hospital in Asheville.

The physicians will keep practicing out of their same offices in Sylva and Bryson City, and keep serving the same local patients they always have. But come January they will be known as Mission Children’s Sylva and Mission Children’s Bryson City.

A new CEO who will take over MedWest-Haywood in December will face the parallel challenges of improving the hospital’s bottom line and capturing patients who travel to Asheville for health care.

Janie Sinacore-Jaberg will become the new CEO of MedWest-Haywood in December.

She is currently the Chief Operating Officer of a 320-bed system in Muskogee, Okla. She has served as the COO and CEO of several hospitals in Georgia, South Carolina and Ohio.

The three MedWest hospitals in Haywood, Jackson and Swain counties laid off 82 employees this week to cope with shrinking revenue and declining patient volume.

The layoffs are part of a larger workforce reduction in recent months. Another 79 positions at MedWest hospitals have been eliminated through attrition.

Smaller, independent hospitals across the nation have increasingly sought partnerships with larger hospitals in recent years, a trend largely driven by financial challenges.

For Highlands-Cashiers Hospitals, the latest hospital in the region to jump on board with Mission Hospital in Asheville, cost savings were certainly a large motivator, although not the only one. While Highlands-Cashiers Hospital loses money on operations every year, that doesn’t mean it is in the red.

Highlands-Cashiers Hospital will soon join the growing number of small hospitals in Western North Carolina to come under the management of Mission Hospital in Asheville.

The hospitals in Jackson and Swain counties formally declared last week that they want out of the partnership forged nearly three years ago with Haywood’s hospital — however, it’s not at all clear whether the leaders of Haywood Regional Medical Center will agree to let them leave.

When Dr. Janine Keever hit the online shoe stores last month to hunt for the optimal pair of white knee-high platform boots, she wasn’t trying to spice up the look of her delivery room scrubs.

Instead, the retro footgear would be the perfect hallmark of her disco attire, donned in good fun and for a good cause during last weekend’s “That ‘70s Gala” fundraiser put on by the MedWest-Harris and Swain Foundation.

Count me among those who hope the MedWest affiliation between Haywood, Jackson and Swain hospitals survives. Otherwise, I fear none of the three hospitals will survive, but instead be swallowed up or severely marginalized in within a decade.

It’s been a tumultuous four years for the hospitals in the counties west of Buncombe. Despite the bumps in the road, though, there seems now at least a path — via the management contract with Carolinas HealthCare — for the three hospitals to move into the future serving pretty much the same role in their communities they’ve been serving for decades.

The county is looking to fill five open positions on MedWest-Haywood’s hospital authority board during a critical time when the MedWest system as a whole is trying to decide its future.

Growing discontent among some Jackson County doctors has the system — which includes MedWest-Harris, MedWest-Swain and MedWest-Haywood — questioning whether the three hospitals should continue on as one connected system, dissolve their partnership completely or simply loosen their bond.