Fresno’s CRMC contract dispute is hurting other Central Valley hospitals, doctor says
Neurosurgical trauma services — used to treat some stroke patients, major head injuries, and spinal injuries — remained suspended at Community Regional Medical Center on Tuesday as part of the fallout from stalled contract negotiations between the hospital and a medical group.
Lauren Nickerson, communications director for the Central California Faculty Medical Group, said the contract impasse remained unchanged Tuesday.
“The negotiations are active and ongoing,” she said.
Neurosurgical trauma services were interrupted at midnight Wednesday night, hours after six neurosurgical trauma surgeons with CCFMG were left without a contract. Funding for 28 CCFMG physicians, including the six surgeons, who also teach at UCSF Fresno, expired last week.
Neurosurgical trauma services are not only needed to treat patients with major head injuries but also stroke patients and spinal injuries, Nickerson said.
Fresno is the only Level I Trauma Center between Sacramento and Los Angeles. That means that as the Creek Fire spreads out of control this week, some top level trauma services aren’t available in the central San Joaquin Valley.
Meanwhile, the suspended services also have a ripple effect on other local hospitals, according to at least one Fresno-area doctor who spoke with The Bee.
Neurologist Alan Birnbaum, president of the Fresno-Madera Medical Society and director of the Stroke Program at St. Agnes Medical Center, said while St. Agnes has some neurological coverage, doctors depend on CRMC’s neurointerventionalist to treat certain patients. CCRMC’s neurointerventionalist is among the six impacted neurosurgeons.
And even before the contract dispute, CRMC’s neurointerventionalist was only able to treat patients Monday through Friday.
“The most immediate impact on me and my patients is that if I have a stroke patient who requires treatment beyond say use of TPA, which is an infused drug, now I no longer have the option, at least during the week, of sending patients down to (CRMC) for treatment,” he said Tuesday.
Any patient in need of specialized treatment for a severe stroke would have to be flown to San Jose Regional Medical Center or Stanford by helicopter, which is “not cheap and carries some risks,” he said.
The Fresno-Madera Medical Society advocates for physicians, patients, and improved healthcare for the overall population, Birnbaum said. The medical society’s executive board is scheduled to have a meeting Tuesday night with the society’s members about the ongoing issue at CRMC, he said.
“Those of us at the medical society have discussed this in some detail, and we are concerned by the route that’s being taken by CMC (that) is really not in the best interests of the community,” he said.
CCFMG officials last week said they had proposed a bridge funding mechanism before the funding expired to continue services as negotiations were ongoing, but CRMC declined the offer. CCFMG officials said over the weekend, they again put forward a proposal to cover neurosurgical trauma services until a funding agreement can be finalized for all 28 physicians, but on Saturday, a temporary solution wasn’t reached.
Nickerson on Tuesday said the bridge funding proposal that was put on the table again over the weekend was for the neurosurgical trauma coverage only.
“It did only include bridge funding for our six impacted neurosurgeons because we understand the importance and the value of that service to the community, although all 28 of our physicians are incredibly invaluable for this community in a doctor shortage,” she said.
Michelle Von Tersch, senior vice president for communications and legislative affairs at CRMC, said hospital officials worked “diligently over the weekend to address CCFMG’s concerns.”
“While we hoped to restore neurosurgical trauma coverage with CCFMG, we also have worked simultaneously to seek alternate coverage,” she said on Tuesday. “We expect to have neurosurgical trauma coverage restored in a day or two.”
On Monday, hospital officials had also stated they were hoping to have those services restored in “a day or two.”
The neurosurgical trauma services are needed for CRMC to maintain its status as a Level I Trauma Center.
Fresno County’s EMS is responsible for overseeing CRMC’s Level I Trauma Center status. A Level I Trauma Center means that all services related to trauma are immediately available, in-house, 24 hours a day, seven days a week. The facility must also be a teaching hospital, officials have said.
Dan Lynch, director for Fresno County Emergency Medical Services, couldn’t be reached for comment Tuesday.
However, on Friday, Lynch told The Bee he had not given CRMC a deadline to fix the deficiency as long as the hospital addressed the problem in a short time.
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