When hospitals squabble over money and turf, the politics of health care take an unseemly turn. The Hippocratic Oath falls by the wayside when patient care becomes secondary to bottom lines.
As Blake Medical Center forges ahead with the creation of a trauma center, which would be the first in our three-county region, three hospitals in St. Petersburg and Tampa want to stymie state approval. Those three -- Tampa General, St. Joseph’s and Bayfront -- all house trauma centers and serve most of Manatee, Sarasota and DeSoto counties. The three joined in a legal challenge against the Florida Department of Health, arguing the state is using an outdated approval process.
Blake’s parent company, Hospital Corporation of America, intends to open trauma centers at several other HCA medical centers in Florida. HCA counters the challenge by noting the rules change frequently and the current approval system should be honored.
The core of the dispute is simple: More competition for trauma patients will be bad for business for the Tampa-St. Petersburg hospitals.
Nevermind patients and their families and loved ones down here.
Motor vehicle crashes are the primary cause of trauma injuries. Assaults, falls and other severe bodily injuries that require specialized emergency treatment also fall into the trauma category. State law dictates that once a paramedic designates an injury as trauma, the patient must be transported to the nearest trauma center.
In Manatee County’s case, that typically means an expensive helicopter flight to Bayfront Medical Center in St. Petersburg. In bad weather, that also could mean a time-consuming ground trip via ambulance -- a delay that can impact patient treatment, recovery and survival.
Should Blake rightfully win state approval, the Manatee hospital would serve the three-county region with quicker access to emergency treatment. But Blake would also take an estimated 500 patients a year from Bayfront. Since trauma centers typically operate at a financial loss, Bayfront asserts in its appeal to the state that a “reduction in patient volume would also increase the losses resulting from the (trauma center’s) operation.”
Is this justification enough to give established trauma centers exclusive rights to patients far away from their usual service areas? Basically, for money? We think not.
Blake seeks Level 2 trauma center status, which requires staffing with a minimum of five trauma surgeons plus on-call specialists and surgeons who can treat almost all forms of trauma. With two new emergency treatment rooms at Blake, HCA’s investment in the trauma center will amount to $2.5 million.
Across the nation, the annual operating expenses for trauma centers typically exceed the charges for the expensive medical care and patient hospital stays. But with more and more hospitals paying independent specialists to be on call anyway, HCA could reduce trauma center costs by hiring those surgeons -- and thus also obtaining their patients as well.
The heart of our free enterprise system is competition, not monopolies. On that point, Blake should win approval. Plus, Florida is not overloaded with trauma centers with only 22. That represents only half the number state law permits.
But most importantly, a local trauma center will allow quicker access to treatment and could save lives -- especially when helicopters are grounded. And a nearby facility will allow families and loved ones quicker, easier visitation, sparing them the time and expense of driving to St. Petersburg.
The Hippocratic Oath concerns more than patient treatment: “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.” A trauma center in Manatee County would better serve that part of the oath.
