For the past 26 years, most people who were seriously injured in Pinellas were rushed to Bayfront Medical Center, the county's only trauma center.
That's no longer the case.
Recent changes to state and local rules means severely hurt victims, especially those in North Pinellas, may instead be hurried to hospitals in Pasco or Hillsborough counties.
Now Bayfront, which wants to be the trauma center of choice for Pinellas residents, is waging a campaign to let people know they can choose where to go.
The hospital took advantage of "Trauma Awareness Month" recently to send out about 3,000 brochures to North Pinellas residents extolling the hospital's trauma center and letting them know, in case of an accident, they can ask to go to Bayfront — even if they're unconscious. The hospital included a wallet-sized card and a car sticker with a picture of the Bayflite medical helicopter and the instruction: "In case of emergency, bring me to Bayfront."
"We're here and dedicated to taking care of trauma patients," said Dr. Steven Epstein, Bayfront's trauma medical director.
It's also about patient volume. Not only is it expensive to maintain a trauma center, the staff also needs to keep its skills sharp. One way to do that, Epstein said, is to see lots of patients.
"It's our skills. Nursing skills. Operative skills. The whole thing," Epstein said. "So, the volume is very important."
Until recently, volume was not an issue. Bayfront, St. Joseph's Hospital in Hillsborough and Tampa General were the only three trauma centers in the area. They had a kind of equilibrium when it came to dividing the work.
But a year or so ago, the for-profit HCA hospital chain pushed its way into the trauma business. It opened the Regional Medical Center Bayonet Point in Hudson in Pasco County and Blake Medical Center in Bradenton in Manatee County.
More recently, the state passed a rule saying EMS must transport trauma victims to the nearest trauma center. There were some exceptions to the rule, such as the one that allows someone to be taken to a hospital of his choice.
Dr. Laurie Romig, medical director over Pinellas' EMS system, then changed the local rules to match the state guideline. Pinellas is divided into three zones: Those injured in the northernmost zone around Tarpon Springs would be taken to Bayonet Point in Pasco. Those in the Palm Harbor area roughly down to Gulf-to-Bay Boulevard would be taken to St. Joseph's. Most people south of there would be taken to Bayfront, although a few would go to St. Joseph's or Tampa General. Romig could not be reached for comment.
Jackie Tolley, spokeswoman for St. Joseph's, said the rule change has had no immediate affect on that trauma center. TGH officials could not be reached for comment. But in the early months of the new rule, Bayfront has seen a big change.
About 1,000 patients a year came into the trauma center by Bayflite over the past couple of years. But in the first three months of this year, only 66 have arrived that way.
It's unclear what factors have contributed to the change. But whatever the reasons, Bayfront spokeswoman Kanika Tomalin said the hospital has seen a "serious erosion" of trauma patients.
Kameel Stanley contributed to this report. Anne Lindberg can be reached at firstname.lastname@example.org.