In the Strug­gle Over Prince Ge­orge’s Hospi­tal, the Ca­su­alty List Grows

The Washington Post Sunday - - Metro -

O ne of Hema Yadla’s pa­tients needed a pace­maker, right away. But when the staff at Prince Ge­orge’s Hospi­tal Cen­ter called to or­der the de­vice for im­me­di­ate de­liv­ery, the ven­dor re­fused to process the pur­chase.

“ They were afraid they wouldn’t get paid,” Yadla, an in­ternist, told me. Luck­ily, an­other ven­dor was un­will­ing to put wor­ries about the hospi­tal’s pre­car­i­ous po­si­tion ahead of a pa­tient’s life. The pace­maker ar­rived, and the pa­tient is do­ing well. But the game of chicken that politi­cians are play­ing with the fu­ture of the county’s largest hospi­tal is en­dan­ger­ing lives and risk­ing a break­down in health ser­vices that could af­fect mil­lions in Mary­land and the Dis­trict.

The Prince Ge­orge’s County Coun­cil’s re­jec­tion last week of a state plan to bail out the county’s fi­nan­cially trou­bled hospi­tal sys­tem may seem like just one more case of brinkman­ship, the sort of ma­cho game that politi­cians play all the time. The coun­cil is in a power strug­gle with the county ex­ec­u­tive and a new gov­er­nor from Bal­ti­more. In the end, most likely, the county and state will ap­ply some ugly old Band- Aid as a tem­po­rary rem­edy and keep the hospi­tal go­ing.

The dam­age is done. An­tic­i­pat­ing a shut­down in June, staffers are search­ing for jobs. “ Most would get out if they got a more stable of­fer,” said David Gold­man, vice pres­i­dent for med­i­cal af­fairs.

“ It’s shocked me how quickly the con­fi­dence of pa­tients and fam­ily mem­bers is erod­ing — it’s by the minute,” said Gary Lit­tle, the doc­tor who

runs the emer­gency room at the hospi­tal in Chev­erly. “ I’ve never be­fore had pa­tients ask me, ‘ Should I go some­where else?’ Es­sen­tially, ‘ Is it safe to be here?’ ”

More than 45,000 pa­tients go to Lit­tle’s ER each year, and even if you begged an am­bu­lance driver to steer you to some other fa­cil­ity be­cause you think of Prince Ge­orge’s as a hospi­tal for the poor, you de­pend heav­ily on the ex­is­tence of its ER. The 115 pa­tients who stream into the ER each day have to go some­where, and the county is not the Dis­trict, where seven hos­pi­tals picked up pa­tients who went to D. C. Gen­eral be­fore it closed.

“ Our pa­tients would be dis­persed,” Lit­tle said. “ They would just dif­fuse out” to Doc­tors Com­mu­nity Hospi­tal in Lan­ham; South­ern Mary­land Hospi­tal in Clin­ton; Prov­i­dence and Wash­ing­ton Hospi­tal Cen­ter in the Dis­trict; Sub­ur­ban, Holy Cross and Wash­ing­ton Ad­ven­tist in Mont­gomery County; and even to more far- flung hos­pi­tals.

“ Peo­ple don’t re­al­ize: 20 ad­di­tional pa­tients a day can grid­lock your emer­gency de­part­ment to a point that be­comes un­safe,” Lit­tle said. “ You can­not add doc­tors and nurses quickly enough to man­age that.”

Add the 3,000 cases a year that the hospi­tal’s trauma unit han­dles — stab­bings and shoot­ings from Prince Ge­orge’s and the Dis­trict were be­ing treated dur­ing my visit — and the re­gional im­pact of a shut­down be­comes fright­en­ing.

Too many years of bud­get con­straints and of­fi­cial ne­glect have left the hospi­tal far be­hind in tech­nol­ogy and equip­ment. The CT scan­ner is woe­fully out­dated. The ER lacks the elec­tronic record- keep­ing and pa­tient track­ing that speed ser­vices at most hos­pi­tals. All but one of the hospi­tal’s res­i­den­cies were cut out, to the great dis­may of doc­tors who trained at Prince Ge­orge’s and have stayed there for decades, com­mit­ted to car­ing for those most in need.

The hospi­tal’s rep­u­ta­tion has suf­fered dearly. All of the doc­tors I spoke with there said they have a devil of a time per­suad­ing their private, pay­ing pa­tients to be treated at the county hospi­tal, yet al­most ev­ery one of the docs and their loved ones have been cared for there.

Sur­geon Said Daee, who has worked at Prince Ge­orge’s since 1976, cred­its it with sav­ing his life: “ I have three stents in my heart; I had it done here be­cause the care is ex­cel­lent. The Prince Ge­orge’s coun­cil mem­bers don’t come to this hospi­tal. They have their surg­eries in Ge­orge­town. But they think noth­ing of push­ing us to the edge of a cliff.”

It may sound slightly ghoul­ish to out­siders, but doc­tors love a place such as Prince Ge­orge’s Hospi­tal Cen­ter be­cause, as Gold­man put it, “ we have very se­ri­ously ill pa­tients who are won­der­ful teach­ing pa­tients. With suf­fi­cient re­sources and good man­age­ment, we’d be­come at­trac­tive to private pa­tients.” Doc­tors get in­ten­sive ex­pe­ri­ence that’s hard to repli­cate at a quiet sub­ur­ban hospi­tal. In a field in which re­peated pro­ce­dures are the best guar­an­tee of qual­ity care, that’s es­sen­tial.

Ali Khan has been a Prince Ge­orge’s sur­geon for 32 years, adapt­ing as the cases that roll into his op­er­at­ing theater have shifted from blunt wounds of car crashes to the pen­e­trat­ing wounds of stab­bings and gun­shots. As we spoke, Khan’s Black­Berry went off: He had to op­er­ate a sec­ond time on a man who was shot five times last week­end. “ He’s go­ing to sur­vive,” the doc­tor said.

In the wait­ing room, the man’s mother smiled through her tears and thanked the Lord, but it was the doc­tors who made the save, as Khan and his team do in 97 per­cent of cases. In a place that politi­cians think they can just toss on the trash heap.

E- mail: mar­c­fisher@ wash­post. com

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.