Cutbacks Could Lead to ‘Major Meltdown’ at S.F. General
Physicians and nurses at San Francisco General Hospital contend that recent cutbacks at the facility could cause a "major meltdown" during the upcoming winter flu season, the
San Francisco Chronicle reports. In a letter to the Chronicle, 10 physicians and nurses at the hospital's intensive care unit wrote, "We are concerned that a limit has been reached beyond which patient care could well be compromised ... We face the winter months, a typically busy ICU time, without the necessary resources to handle the expected increase in patients." Citing budget constraints, San Francisco General closed a six-bed ICU in July. According to some physicians, that closure -- and the resulting loss of needed ICU beds -- has created backlogs in the emergency room and delays in some surgeries. Dr. Alan Gelb, director of the hospital's emergency department and chief of staff, said, "We are gridlocked almost all of the time. We've reached a critical level of underfunding, where it affects everything, from nursing to the physician staff to trash collection."
Physicians also contend that "morale is sinking fast," a problem the facility's executives blame on a nurse shortage rather than budget cutbacks. San Francisco General Executive Administrator Gene Marie O'Connell said, "The biggest concern right now isn't having enough funding, it's getting enough people hired." Currently, the hospital has seven full-time nursing vacancies. O'Connell noted that the rising cost of living in the area is adding to recruiting problems. While physicians argue that more funding from the city would help, O'Connell said, "Just throwing a lot of money at the problem won't fix it. If I could get the nurses, I could open the ICU tomorrow." Hospital spokesperson Gloria Rodriguez said that the city already has budgeted $79.5 million -- the most in history -- in general fund revenues for the facility. Doctors countered that the figure includes $19 million already earmarked for the mental health facility adjacent to the hospital. Physicians and administrators agreed that declining Medicare and Medi-Cal reimbursement rates, stemming from the 1997 Balanced Budget Act, were the underlying cause of the facility's problems (Russell, San Francisco Chronicle, 11/14).
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