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Meeting airs both sides in fight over Florida trauma centers

TAMPA — Floridians who have suffered critical injuries added their voices Friday to the heated debate over which hospitals should have trauma centers.

Patients and family members joined hospital executives and trauma surgeons speaking at a five-hour workshop in Tampa. It was organized by the Florida Department of Health to seek public input into the discussion.

This weekend, an independent team from the American College of Surgeons will meet in Tallahassee to study the trauma system and give recommendations.

The issue has been the subject of legal wrangling ever since the state allowed the HCA hospital chain to open new trauma programs around the state, including Regional Medical Center Bayonet Point in Hudson and Blake Medical Center in Bradenton.

Late last year, Florida's second-highest court declared invalid a 20-year-old rule used to justify new trauma programs, handing at least a temporary victory to established programs that argued they would be hurt by the loss of trauma patients.

Since opening in November 2011, Bayonet Point's trauma center has treated more than 1,800 patients — almost all from Pasco and Hernando counties. Previously, many of these patients would have been taken to Tampa or St. Petersburg. One of them was 78-year-old Paul Judson of Spring Hill, severely injured in a car wreck just days after the Bayonet Point program opened.

"How lucky I was to have them there," he said, noting that the hospital is 14 miles from the site of his accident. "It would be great if all the citizens in Florida would have had that kind of advantage."

But the region's existing trauma programs — Bayfront Medical Center, Tampa General Hospital and St. Joseph's Hospital — say they were serving the community well through a system that includes air and ground transport. After suing the state and HCA, their recent victory triggered the call for new rules.

From the start, the established centers said the loss of patients to new programs could hurt not only their finances, but also quality of service. Experts agree that treating many patients is necessary to keep skills sharp.

Friday, officials from Tampa General said they have seen about a 20 percent decrease in trauma admissions. The only Level 1 trauma program and burn unit in the region, equipped to receive the most severely injured, it also has seen transfers from other hospitals drop 30 percent.

Bayfront Medical Center in St. Petersburg reported a 68 percent decrease in trauma patients from outside Pinellas County in the first half of 2012. It did not send a representative to the workshop Friday, however.

Opening new trauma programs "may be great for one community, but it may be absolutely terrible for another community," said St. Joseph's chief medical officer Dr. Mark Vaaler.

After the meeting, the Health Department issued a statement saying it now considers the HCA centers, which had been operating under a provisional status, to be full-fledged trauma centers. The action completes their application process — despite the pending legal case.

State Surgeon General Dr. John Armstrong said nothing of the development during his public remarks at the workshop.

"We are here for reconciliation," Armstrong told the gathering, stressing his interest in a trauma system that is "inclusive, sustainable and focused."

But representatives from St. Joseph's and Tampa General expressed concerns that the state hasn't been specific about how it plans to rework the rules underpinning Florida's trauma system.

Stakeholders also don't know how this weekend's expert guidance will factor in, although the American College of Surgeons review has long been requested by state trauma professionals.

"Since we have no idea what they are really trying to do with the rule, our input is in a vacuum," Vaaler said.

He also questioned the lack of Florida experience among the surgeons group, stressing the state's unique geography and demographics. But state officials said it would yield unbiased guidance.

As he rushes to hold six public workshops, including the Tampa visit, in eight weeks, Armstrong noted that Florida currently has no way to approve trauma programs. Eight more hospitals have expressed interest in them.

While trauma experts asked for decisions to be based on data, not anecdotes, Pasco and Manatee residents were passionate about their need for trauma services close to home.

"If I had been in Tampa or Fort Myers, my family might not have been able to be there for me as much to be supportive," said 31-year-old Sarah Ziebro of Venice, who was treated at the new trauma program at Blake Medical Center after being attacked by a bulldog last summer.

"I can't imagine if that wasn't there what I would have done."

Letitia Stein can be reached at lstein@tampabay.com or (727) 893-8330.

Meeting airs both sides in fight over Florida trauma centers 02/01/13 [Last modified: Friday, February 1, 2013 11:15pm]
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