Scaled-down operation mulled for Doctors Medical Center

West Contra Costa Healthcare District

A number of alternatives have been identified to provide emergency services to West County in the wake of continuing financial issues at Doctors Medical Center, according to leaders of a stakeholder group formed to address the crisis.

Dr. William Walker, Contra Costa Health Officer and the leader of the stakeholder group, updated the West Contra Costa Healthcare District Board on the group’s progress during a meeting Tuesday. Walker said the group is focusing on two scenarios for interim services while a long-term alternative is found.

One scenario calls for a scaled-down hospital that retains the same number of emergency beds and 15 beds for acute medical, surgical and intensive care patients.  The stakeholder group is also considering a satellite emergency department at the current location.

“I want to be clear that under all the scenarios we have identified as appropriate for study, Doctors Medical Center is reduced in size and scope of operations,” Walker said in a statement. “It is unrealistic to continue to push for the retention of a full-service hospital given that losses continue to mount, despite a 20-year effort to save Doctors Medical Center.”

The group was formed at the request of the Healthcare District to evaluate an alternative to a full-service Doctors Medical Center, which despite extensive efforts to reduce costs faces losses of $18 million annually.

The stakeholders are focusing on maintaining emergency care, which was identified as the most important need in the region in an earlier study by the county Health Services. It would be supplemented by an increase in same-day appointments at West County health clinics.

In his report to the board, Dr. Joseph Barger, medical director for Contra Costa’s Emergency Medical Services Agency, said he and the emergency room physicians at the region’s hospitals believe that a satellite emergency department is clinically viable. Barger is leading an effort to coordinate emergency services and transportation issues with the region’s hospitals.

“We are modeling out the various alternatives to determine which services are affordable and the most essential,” Walker said. “Our goal is to ensure that the services retained provide the maximum amount of care in a way that is self-sustaining.”

Despite the persistent financial losses, many of the doctors and nurses at DMC are publicly opposed to anything less than a full-service hospital and have demanded the county step in and provide funding. But Walker reiterated Tuesday that the county cannot afford to take over operations.

“The county is not in a position to adequately fund or take over Doctors Medical Center, particularly given the changing and uncertain nature of the health-care marketplace,” Walker said in his statement.

The stakeholder group was announced in June by members of the Hospital Council of Northern and Central California and Contra Costa Health Services. It is comprised of representatives from the county, physicians, clinics, the West Contra Costa Healthcare District, the state Health and Human Services Agency and top executives of Kaiser Permanente, John Muir Health, Lifelong Medical Care and Sutter Health. It also includes experts in health-care finance, medical law and reimbursement who are funded by the member hospitals of the Hospital Council.

The stakeholder group is expected to make its recommendation to the district board shortly, with the goal of having an interim care alternative in place by Sept. 1. The resulting expense reductions will keep essential services operating while long-term options are evaluated.