Emergency!

Impact of ER shakeup unclear

By George Schwarz
The Amarillo Independent

The Amarillo Independent learned on Friday that the group of physicians serving the emergency room at Northwest Texas Healthcare System has given notice to the hospital's administration that it will end its contract in 90 days.

Courtesy photo Emergency: Northwest Texas Hospital, which provides the vast majority of charity care in the Amarillo community, faces the loss of the Amarillo Emergency Physicians group, which bolted to Baptist St. Anthony's Health System.

The Indy was the second media outlet behind Channel 7 and the first print outlet in Amarillo to report the situation, posting the bulletin to the amarilloindy.com Web site at 7:15 p.m. Friday, only hours after the group notified the hospital of its plan to leave.

The notification to Northwest was delivered to the hospital while its chief executive, Frank Lopez, was out of town on business.

"We made a business decision," said Dr. Stephen Neumann. "We have given Northwest notice as called for in our contract."

The group will begin staffing Baptist St. Anthony's Health System's emergency room "sometime in June," said Mary Barlow, director of corporate communications for BSA, adding she didn't know if it would be at the beginning or end of June.

Neumann declined to discuss the terms of the deal in detail or why the group bolted to BSA, but added, "I am one that is concerned about the welfare of the community and am absolutely convinced, and I think you'll get the gist of it when you get the press release, that BSA is committed to doing things that will be good for the community."

He said he wouldn't have made the move if he didn't think BSA was going to do good things for the community.

But one trauma surgeon said the move by BSA confirms the concern many in the medical community have had about the BSA emergency services' quality of care.

"The biggest implication I would make, personally, is to say that this validates the commentary that BSA never provided appropriate emergency room care to this community, and they're now doing so and they are finally getting a qualified emergency room group," said Dr. Dennis Dove, regional chairman of surgery for Texas Tech School of Medicine.

BSA hasn't been "forthcoming" about the level of care it has provided the community, Dove said, adding, "So, no matter what they've been saying about the level of care that they have been providing in the past, they have finally validated the absence of appropriate care by hiring a group of board certified, trained emergency room physicians."

"I know that Mary Barlow has released a press release," Neumann said. "I don't know that it's been released widely, but I know that it's out there and available to news outlets at this point."

Last week, Barlow's statement to the Independent didn't square with Neumann's remarks.

When asked directly if BSA had issued a news release or was going to do so, Barlow said, "No."

Barlow said she didn't know if BSA would apply for a high-level trauma center designation nor could she say when the deal was consummated.

This wasn't the first time BSA has tried to poach the emergency room physicians from Northwest.

A source close to the situation who requested anonymity confirmed that BSA had "approached" the emergency specialists about 18 months ago.

Late Friday night, Lopez said the move was a surprise but affirmed Northwest's plan to continue providing a trauma center for the community.

"We are committed to maintaining our trauma certification and should the Amarillo Emergency Physicians group move to BSA, we will recruit a new group to provide the same caliber of service that we have provided the community in the past," he said.

On Monday, Lopez circulated a news release that was, he said, a re-write of an internal memo that went to Northwest employees and physicians.

"We have had a positive working relationship with this group and our preference is to retain their services. However, if this is not possible, we are committed to maintaining our Level III Trauma designation along with all related emergency services provided to Amarillo and the surrounding communities," the release stated.

He also invited those doctors who are part of the Amarillo Emergency Physicians Group who want to remain at Northwest to do so, adding, "Preliminary discussions have been initiated with providers of emergency medical care that are available to meet our needs."

Dove said it was clear Northwest would recruit other emergency physicians and the impact on local physician training should be minimal.

"The impact regarding trauma care should remain unchanged because as Northwest replaces the emergency room physician group, our trauma practices should continue as is."

But the bigger question, Dove said, is whether the community needs competing services. With two trauma centers, the quality of care could be diluted because specialists backing up the trauma doctors would be pulled between two competing institutions.

Dove said that if BSA provided emergency and trauma indigent care, as Northwest does, it could help the community.

"It would be wonderful that they would begin to participate in the delivery of care which is not known for major economic reimbursement," Dove said.

"It would be extremely beneficial to have them share some of the economic burden of providing trauma care to the community."

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Posted: March 6, 2008