Hospital readies on-call plan
Hospital employees and physicians have been debating which emergency on-call services should be available at Tahoe Forest Hospital.
The hospital board began to examine emergency on-call services several months ago when gaps in coverage appeared in medicine and general surgery coverage as well as some other specialties. The main issues identified by the board were:
– Identification of what services should be readily available to patients who enter TFH emergency facilities.
– Determination of what should reasonably be expected of a small rural facility in terms of specialty coverage.
– Consideration of how physicians should be compensated for their availability.
– Determination of realistic needs assessment of our growing regional community.
– Determination of who should be called upon to finance these services.
Some of the medical emergency services are required by the hospital’s license and by federal or state law. Others are made available according to the capabilities of various specialties. Others can be provided by the hospital.
“We are now discussing which medical specialty – general surgery, pediatrics, anesthesia, radiology, etcetera – the hospital should have a role in providing, beyond the capabilities of that group of physicians,” said hospital board member Rob Eskridge.
Two board committees have created two policies that address these issues, both in draft form. The emergency on-call policy intends to create a system that is voluntary, fair and equitable without unnecessary financial burden to physicians or the hospital. The emergency services plan outlines physician services that would be available on an on-call basis for emergency services.
Last week the board and staff met again with physicians and employee groups to get more input on the issue and feedback and draft policies.
“It was mainly an input session and it was a great turnout,” TFH board member MaryLou Sullivan said. “Physicians explained to us things that hadn’t occurred to us … There is a wide range of opinions and a lot of solutions offered.”
Some of the input included differentiating between true emergencies and urgent care medical issues, the need to recruit additional doctors and what to do with round-the-clock coverage for certain medical specialties.
“Consumers have come to expect that any medical problem can be handled by the emergency room, when in fact many medical problems require a surgeon or another specialist,” Eskridge said. “The more emergency calls that doctors get, the longer patients in their offices have to wait.”
“Our community must actively recruit additional doctors, especially younger ones,” he said. “Doctors are not required to take emergency calls after age 55, which puts the emergency burden onto too few doctors unless younger talent is coming into the community.”
These are issues that many similar rural hospitals in the country are forced to face, and finding solutions can be very difficult.
“I think we’re closing in on a solution,” TFH CEO/Administrator Larry Long said. “It’s a very complex issue. There are many facets and angles to be looked at. We’ve got a lot of ideas and not all of them can be integrated. The goal is to come up with the best fit with the needs and the resources we have to work with.”
The board will hold a special meeting on Monday, Feb. 12 at 3 p.m. and is expected to approve a policy.
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