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In Poor Health : Family Practice Program Ends; What Next for Those It Served?

May 14, 1989|GERALD FARIS | Times Staff Writer

Psychiatric hospitalization services ceased May 5. Dr. Thomas Dale, chairman of the psychiatric department, said the department will continue to offer consultation and emergency care.

He called closure "a real loss to the community" because psychiatric patients will have to be transferred to Long Beach and Torrance for hospitalization. "I was there for 16 years . . . the one who opened the place," he said. "I'm very saddened by the closure."

Dale said similar closures are occurring at hospitals across the country because of sharply declining patient loads due to cutbacks in insurance coverage. He said that on an average day, his department had 15 hospitalized patients.

Wilson said the board action was based on recommendations from the national accounting firm of Ernst & Whinney, which was retained by the hospital in the wake of an estimated $8 million in losses during 1987 and 1988. The firm, in a plan designed to put the hospital back in the black, identified areas in which money could be saved and recommended elimination, sale or lease of some services and enhancement of others.

Wilson said a "lot of soul searching" went into the board decision about cuts. "The need for change is compelling," he said. "It's tough for the people involved in these programs, but it's best for the hospital to become a viable institution in the future."

For his part, Avina praised San Pedro hospital's medical staff and acknowledged that the hospital has financial problems to solve. He said his criticism stems more from the abrupt way the hospital is shutting down the residency training program than from the shutdown itself.

"(Residents) have signed contracts with the hospital . . . and in May, 1989, they have the hospital say, 'We feel we won't honor this contract,' " he said. "It's quite a shock."

Of the 14 resident physicians in the three-year program, four will graduate in June. Avina said the future of the others who still have training to complete is up in the air. "They don't know where they can go," he said.

Avina said some of them may have to wait a year before resuming their training.

Four physicians who were due to start their first year of residency in July have been placed in other family practice programs. Three will be in Southern California--at Los Angeles County-Martin Luther King Jr.-Drew Medical Center in Willowbrook, White Memorial Medical Center in Los Angeles and the San Bernardino County Medical Center. The fourth will go to a program in Columbus, Ohio.

Although there is an escape clause in the contracts for the hospital in the event the training program is canceled, Avina said the resident doctors have retained an attorney.

Of the residency program's 3,200 active patients, he said, 95% are on Medi-Cal. Wilson said hospital obstetric physicians have agreed to care for 200 who are expectant mothers. Avina said 600 to 700 of the patients are children and will receive care because they are covered by Crippled Children's Health and Disability Prevention, a state-subsidized insurance program.

But he is pessimistic about the future care of the others, saying many will wind up in emergency wards because they "will not have had continuous health care provided for them, and their chronic illnesses will become acutely worse."

Wilson was more optimistic, saying that physicians in San Pedro will accept Medi-Cal patients. But he conceded that "some may have to leave town."

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