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Hospital directors express doubts

(Published September 4, 2000)

By OSCAR ABEYTA -Staff Writer

Donna J. McKenzie-Banks is one of dozens of demonstrators protesting staff cuts at D.C. General Hospital Aug. 30.

As the cityís only public hospital prepares to slash its workforce and services, members of its governing board have expressed concern that the pace of changes being made is too fast and could harm healthcare service delivery in the city.

Only half of the Public Benefit Corp. Board of Directors voted in favor of a plan that would scale back D.C. General Hospitalís services -- eliminating in-patient care, obstetrics, pediatrics, most surgery and replace the Level 1 trauma center with an urgent-care center that would only be able to stabilize major trauma cases and ship them to other hospitals.

Six members of the board favored the plan in the Aug. 25 vote, two voted against, two abstained and two were absent. PBC oversees D.C. General, the cityís public health clinics and the school nurses program.

Hospital officials are expected to release this week a list of 550 positions that are to be eliminated at the hospital. Because of union and city personnel regulations, the hospital would not be able to begin laying off people until October.

Director Lee Partridge said she voted against the plan because she felt the board was moving too quickly and without enough information about the impact its actions would have.

"We were reviewing three options for actions to take," she said. "By the time decision time came, we still didnít have solid financial analysis of any of the three options."

Board member Martin Davis said the board is moving in the right direction but much too quickly, which is why he said he abstained from the vote.

"While I applaud the way the city is moving toward primary care and away from the hospital, I just think it was a little too much, a little too soon," Davis said. He said ideally the city should have taken five years to transition from a large public hospital to the "community access center" that will replace it.

"What you have to do is re-educate the population not to drop people off at the emergency room when theyíre sick," he said. "What you need to do is go to a doctor before you get sick."

He said the national trend is toward moving people from reliance on hospitals to primary care physicians, even the uninsured and Medicare patients.

"When youíre asking for hospitals youíre asking for yesterdayís medicine," he said. "This is left over from the turn of the century when hospitals were there for poor people. We sell poor people on the idea that they need a hospital when in fact they need a doctor."

Partridge, however, said the board acted without knowing whether the uninsured would have sufficient access to emergency room care.

"What you need to be able to provide is assurance that there will be Level 1 trauma access for all patients somewhere else," she said. "We (the PBC board) didnít know where that somewhere else was. We didnít have any discussions with anyone (at other hospitals) to see if they could absorb the cityís uninsured patients."

The Common Denominator reported Aug. 28 that the D.C. Hospital Association sent letters in July to key members of Congress who oversee the D.C. budget stating that the cityís private hospitals would not be able to absorb the number of uninsured patients treated by D.C. Generalís trauma center. Association president Robert Malson said other hospitals could close their emergency rooms because they are unable to absorb the costs of additional uninsured patients.

Partridge said that the hospitalís financial problems are paramount and need to be addressed in some manner.

"It couldnít be ignored and had to be dealt with," she said.

D.C. City Councilís Committee on Health and Human Services is scheduled to hold an oversight hearing about D.C. General Sept. 27.

Copyright © 2001 The Common Denominator