The president of Bayfront-St. Anthony's says both hospitals are needed currently.
For 60 years or so, St. Petersburg's two largest hospitals have run on parallel paths. Less than 2 miles apart, Bayfront Medical Center and St. Anthony's Hospital have managed to treat heart attacks, cut out cancers, fix broken bones and deliver babies _ even when some patients had no way to pay.
Two years ago, the hospitals merged to cut costs and fend off a nationwide squeeze on hospital revenue.
Now, with operating losses approaching $1-million per month, the board of Bayfront-St. Anthony's Health Care has found itself grappling with a tough question that could touch the hearts of generations of St. Petersburg residents:
Does it make financial sense to keep both hospitals open?
"The board has talked about that in the past and will continue to talk about it," Bayfront-St. Anthony's President Sue Brody told the St. Petersburg Times editorial board Thursday. "But right now, both hospitals are viable and we will continue as one clinical enterprise with two primary campuses."
Among other problems, both hospitals are serving fewer patients, Brody said. All over the country, new technology has promoted a shift of medical services to outpatient clinics and doctors' offices. Managed-care companies constantly push for shorter hospital stays.
In this year's second quarter, Bayfront filled about 46 percent of its 489 beds, down from 52 percent from the same time last year, according to documents filed with the state. St. Anthony's filled about 40 percent of its 385 beds in the second quarter, down from 42 percent the year before.
These figures will rise during the winter, when the area's population grows. And no hospital can operate at 100 percent capacity. So right now, one non-profit hospital cannot meet south Pinellas County's needs, board member John Welch said.
"If we continue to have a patient load reduction, maybe we'll get down to the point where we need only one campus and then comes decisionmaking time," Welch said. "But right now we need both."
Welch also dismissed rumors that Bayfront's Level II trauma care might be eliminated. "That is certainly not under consideration," Welch said.
Three BayFlight helicopters that rush accident victims to Bayfront from several counties may lose money on the surface, Welch said, but they bring in patients, generate "an incalculable amount of good advertising and promotion and . . . save a lot of lives."
Concern over the hospitals' fortunes has swelled in recent weeks as cost-cutting layoffs became public. With 2,700 employees, Bayfront-St. Anthony's cuts a big swath through the local economy.
Besides merging with each other, the hospitals also joined BayCare Health System, a regional network of eight non-profit hospitals that is directed from an office in Clearwater.
Some Bayfront-St. Anthony's employees whose jobs were eliminated may be reassigned within the two hospitals or may be hired for positions in other BayCare hospitals, Brody said.
BayCare has also saved millions of dollars for its participating hospitals by consolidating administrative functions, negotiations with managed-care companies, purchase of supplies and other operations, she said.
But such assurances haven't eased fears that medical care in South Pinellas is being undermined.
"I feel radically misled," said St. Petersburg City Council member Jay Lasita at Thursday's council meeting.
Lasita and other council members said BayCare executives were not up-front during a 1997 debate about the far-reaching impacts of the alliance. That discussion left the impression that the only change would be better buying power, council members said.
"I remember clearly saying to these guys some two years ago we didn't want to see any lapse in service," said council member Frank Peterman.
"I have some grave concern about who's making medical policy," said council member Kathleen Ford.
The city has some leverage in the debate. It owns the land beneath Bayfront Medical Center and since 1968 has leased it to the hospital for $10 a year. In 1997, the council agreed to modify the lease, allowing Bayfront to join BayCare.
The council invited Brody and BayCare president Frank Murphy to a special session at 3:30 p.m. Aug. 24 to discuss changes since BayCare was created.
"There's a lot for the council to be concerned about," said council chairwoman Bea Griswold. "They didn't say anything about such reductions as seem to be happening."
Council member Larry Williams asked the legal staff to research how the city could "unwind" the lease to force Bayfront's withdrawal from the BayCare alliance.
"Now they're laying off people, and that has an impact on the city's economy," Williams said.
Another issue involves Bayfront's decision to stop aborting fetuses with genetic defects such as Down's syndrome _ a concession to its Catholic partners in the BayCare alliance.
City Attorney Michael Davis is researching whether Bayfront's new abortion policy violates the city's lease, which requires that the premises be operated without regard to race, sex, color, or creed.
Davis and his staff are meeting with Brody on Friday.
Two activists from the National Organization for Women said women's rights to emergency contraception, abortion and privacy are being violated. They asked to address the council again as the issue is debated.
"We are concerned about abortion," said Toni Van Pelt, NOW's state president. "But we are also concerned about the full broader issues of contraception."
Mayor David Fischer wasn't as alarmed as the City Council _ in part because he said he doesn't have enough information. He does want answers from Brody, whom he called "easily accessible and up-front" about layoffs, abortion policies and changes in services.
"I think the problems may be a little deeper than religious doctrine," Fischer said. "I think the services are shifting."
_ Times staff writer Kelly Ryan contributed to this report.