Why DMC Hasn’t Closed Yet
By Dr. Sharon Drager
If money were the only consideration, DMC would have closed years ago. Its financial challenges are no different than they have been. Hospitals close all the time; however, except for rural hospitals, there are usually other hospitals in the community to pick up the slack. So when Los Medanos closed, Sutter Delta was just down the road; the community still had a hospital and most of the medical staff was intact. The situation in West County is different, and everyone knows it. That’s why there’s a reluctance to see it close. DMC is not just the only public hospital in West County, it’s the ONLY hospital except for a Kaiser facility that has to take anyone who shows up in the emergency room, but is not open to the public for anything else.
Hospitals are ecosystems, not just inpatient facilities. In West County a medical community rich in specialists has grown up around DMC and cares for a community that has a high burden of chronic illness. So, when the hospital closes, so does the Cancer Center (radiation and chemotherapy), a busy Wound Care Center, advanced heart attack care, advanced comprehensive care for dialysis patients and comprehensive care for surrounding nursing homes, among other services.
Physicians won’t practice for long in offices surrounding a dead hospital. Many surgical specialists cluster around hospitals, which are their work places. They will disappear form West County and won’t be replaced.
The Hospital Council’s assertions that an Urgent Care Center will fulfill the needs of the community are disingenuous. Yes, many patients visiting any ER can be treated as outpatients, but many require advanced imaging, consultations and fairly aggressive treatment to allow them to go home. Urgent Care centers associated with hospital systems do can work like this but not small stand-alone units attached only to primary care clinics.
West County is in a relatively isolated position for an urban community as far as heart attack care is concerned. Without DMC, heart attack patients whether they’re Kaiser members or non-Kaiser members and whether they live in Richmond or Kensington have to be transported to Concord or Oakland. A 10-minute trip becomes an eternity.
The new hospital model for West County residents will be strictly 20th century, not up to date. Patients who require inpatient care will be treated episodically at whatever institution has room for them, often with a new set of specialists every admission. Kaiser has a vaunted coordinated care system, which applies only to its members. The default mode for non-members at Kaiser hospitals is “treat and street.” Pat Frost can argue that no one has yet died in an ambulance, but I know complicated patients who died because they were shipped to unfamiliar hospitals.
Finally, while I hope the community will consider a parcel tax, it is grossly unfair to tell West County residents that they don’t merit a hospital because they didn’t support another parcel tax. No one, including the editorial board of the Contra Costa Times, has ever suggested that residents of Walnut Creek or San Ramon or Antioch don’t deserve a hospital because they don’t pay a property tax. I guess those people are just luckier.
Dr. Sharon Drager is a vascular surgery doctor in San Pablo.