By Jason B. Johnson
THE SAN FRANCISCO CHRONICLE (California)
Copyright 2006 The Chronicle Publishing Co.
All Rights Reserved
A financial crisis at the hospital that serves some of West Contra Costa County’s poorest patients prompted authorities to take the unprecedented step Monday of closing the emergency room to ambulances.
Ambulances are being forced to bypass Doctors Medical Center in San Pablo and will instead be diverted to Kaiser Medical Center in Richmond and Contra Costa Regional Medical Center, a county hospital in Martinez.
In a meeting Wednesday night, the elected board that oversees the hospital approved a measure to file for bankruptcy.
Board members of the West Contra Costa Healthcare District, however, deadlocked on a provision to close the medical center’s emergency room.
Board members supporting closure feared that leaving the emergency room open will eventually force Doctors Medical Center to shut down due to financial problems.
The two-hour board meeting in the hospital’s basement attracted hospital staff and local residents who made emotional speeches about whether keeping the emergency room open would ultimately doom the financially struggling institution.
After the meeting, Doctors CEO Irwin Hansen said he will continue to divert ambulances and take other actions to severely cut back emergency room and other services.
Options recommended by Hansen at Wednesday’s meeting and approved by the board include closing the medical center’s smaller Pinole campus, obtaining an emergency loan to reinstate services, cutting staff wages, furloughs and closing the obstetrics department.
But two members balked at the prospect of reducing the emergency room’s status to that of an urgent care center.
“If we don’t do this, then we’re going to lose this facility,” board chair Beverly Wallace shot back.
Board member Deborah Campbell, choking back tears at one point, argued that keeping the emergency room open would not force the hospital to close. She was joined in opposition to the closure by fellow board member Betty Moore-Cash. Their no votes drew applause from the crowd of about 200 people in attendance.
But Hansen said the hospital’s emergency room will remain on diversion for the foreseeable future, and warned that deeper cuts must now be made to payroll and to other services to compensate for not closing the emergency room completely.
“The consequences will be greater because of the board’s decision,” Hansen said.
The hospital now serves residents in unincorporated Contra Costa County and the cities of Richmond, San Pablo, Pinole, Hercules and El Cerrito. Hospital and county officials said closing the hospital and its emergency room would be a major blow to the region.
“We’re quite concerned about the possibility of closure,” said William Walker, director of Contra Costa County health services. “The county, health department and EMS (Emergency Medical Service) will do what it can to fill any void that arises.”
Tenet Healthcare operated the hospital under a lease for seven years until 2004, when it returned operation of Doctors to the West Contra Costa Healthcare District. About 20 percent are on MediCal, which offers low reimbursement rates.
Tenet reported a loss of $24 million in 2004. The Healthcare District reported a loss of $15 million in 2005. “By far we’re the busiest emergency room in Contra Costa County,” said hospital spokeswoman Gisela Hernandez. “A disproportionate share of our community is uninsured, and it’s a working-class community.”
The diversion so far has not put a strain on other hospitals. “So far we haven’t seen a huge impact of inpatients or outpatients,” said Kaiser Richmond spokeswoman PJ Ballard. “Although we’re aware of what’s going on, and patients’ safety comes first.”
Doctors receives about 20 ambulances each day, including patients suffering from heart attacks, strokes, broken limbs and asthma attacks. Most critical trauma patients -- victims of life-threatening gunshots -- are taken to the county’s trauma center at Walnut Creek’s John Muir Medical Center, said county emergency services director Art Lathrop.