At the end of December, another Cleveland emergency room is going out of business. Saint Luke's Medical Center, on the city's east side, has announced plans to close its emergency room and open a new Urgent Care Center. One of the ironies of the situation is that Saint Luke's as a hospital ceased to exist two years ago. Nearby residents, frustrated by years of changes, are feeling hostile about this transformation. Meanwhile hospital administrators are working to convince their neighbors, clients, and local politicians, that the intent behind this change is based on medical realities, not financial ambition. 90.3 WCPN's April Baer reports.
April Baer- The frustration level is running high among residents of the Buckeye, Shaker, and Mount Pleasant neighborhoods. A recent community meeting showed just how high.
Area Resident- I think it's a disgrace and a shame.
AB- This area resident, in his late 40s, asked that we not identify his name. He's angry at the news that Saint Luke's emergency room is about to be dismantled. At this meeting, medical administrators explained to about 80 members of the community that the ER is steadily losing millions of dollars per year, treating the kind of illness that should be handled by any primary care physician. Saint Luke's is run by a partnership between the Sisters of Charity of St. Augustine and University Hospitals of Cleveland. The partnership is planning to shut down the ER at the end of the year, and replace it with a scaled-back, Urgent Care Center for walk-in, chronic and acute illness. This is not the resolution most of these residents were hoping to hear.
Area Resident- The people will not get any treatment after 10 o'clock, the doors will close at nine. This will not help the neighborhood. The neighborhood needs a hospital. This is all being done by design. So the people won't have anywhere else to go.
Jenny Hovanen- I don't think anyone is more disappointed with the closure of Saint Luke's than we are.
AB- Jenny Hovanen is Public Relations Director for the partnership that manages Saint Luke. She insists that while there are clearly unmet health care needs in the surrounding neighborhood, meeting those needs has proved to be no simple task.
JH- Over the last two years we've worked extensively with the community to make them aware of the services on the campus, but the statistics tell the story. The usage of the emergency department remains low.
AB- Business at the ER is pretty slow, judging from a visit one day this week, at which time the only occupants of the waiting room were pair of toddling girls waiting for their mother. Saint Luke's nurse manager Julie Terlizzi, who's been here for 13 years, says the problem's not just volume. She sees patients coming in for conditions like sore throats, simple wounds--things that a family physician should see and follow up on.
Julie Terlizzi- I feel frustrated for them because I think they're missing out on a very important relationship they could develop for themselves and their family members. There's nothing like a good relationship with a primary physician or pediatrician for ongoing medical care. They get to know you, they get to know things you might not even know about yourself. Coming into this type of setting for everyday care - they patient really doesn't benefit from that kind of relationship because the physicians change regularly, and it's just not the same.
AB- The trend Saint Luke's is reporting - misuse of the emergency room - is a common complaint at every emergency room in town. Many times, physicians say their patients meet them in the ER because they cannot afford to make regular office visits. The Federation for Community Planning estimates that at least one hundred thousand people in Cleveland are without health insurance. It's not that hospitals don't want to, or aren't, caring for the uninsured - it's that they're spending tens of millions of dollars doing it, expenses that are often never reimbursed.
Just as the facts of medical economics have driven the city's poor to rely heavily on emergency care, they've also driven local leaders to take a special interest in what's happening at Saint Luke.
Congresswoman Stephanie Tubbs Jones, and Cleveland's Mayor-elect Jane Campbell both attended this month's public meeting on the ER phase-out. The hospital's gone through many incarnations over its tumultuous one hundred four year history. Mrs. Campbell said at this month's public meeting she doesn't hold Saint Luke's management responsible for the numerous turnovers and cutbacks in the hospital's long history.
Jane Campbell- While we're here having this discussion about what to do now, the decisions affecting Saint Luke's were made, I think, several years ago.
AB- But she indicated she does expect the administration to uphold its commitment to the community. Back when Saint Luke's - the hospital - was closing, Mrs. Campbell, as a Cuyahoga County Commissioner, voted in favor of issuing county bonds to help pay for improvements made to the medical campus. This was done with the understanding that the Partnership would preserve some services - and inform the public if those services would be cut back. Now that the cutback has arrived, Campbell says she wants a guarantee that people who comes to the new urgent care center will pay no more than they did at the ER.
Hospital administrator Alan Channing said he would make a recommendation to that effect to the Partnership's Board. It's not known yet if his recommendation has been adopted.
It's also not clear that the long-suffering neighborhoods around Saint Luke are at peace with the change that's coming. Many neighbors know that the Partnership has big plans to redevelop Saint Luke's medical campus. Those plans will include health facilities, and also residential and retail space. As they move forward with the project, administrators will have to fight a widespread belief that the ER is being closed to accommodate a lucrative development deal, at the expense of public health, although many observers also admit Saint Luke has been working under difficult conditions. Community advocates like Vel Scott are hoping a balance can be struck.
Vel Scott- My concern is that infant mortality will go up. People don't have transportation - it's hard for them to reach other hospitals. Saint Luke's is a very large facility. If they're going to offer some kind of primary care, that's a good thing. But we still need an emergency room.
AB- The new Urgent Care Center is scheduled to open around the corner from the old ER, the first week of the new year. April Baer, 90.3 WCPN News.