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April 07, 2004

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Publication Date: Wednesday, April 07, 2004

South County medical care options could diminish, some public officials, medical professionals fear South County medical care options could diminish, some public officials, medical professionals fear (April 07, 2004)

By Renee Batti
Almanac News Editor

On the list of concerns voiced by medical professionals and county officials about Palo Alto Medical Foundation's plan to build a new hospital in south San Mateo County, the fear of diminishing health-care options for the public is up near the top.

That concern is due in part to what some see as an uncertain fate for Sequoia Hospital, a community hospital operating out of Redwood City for some 34 years. With the well-funded Sutter-affiliated Palo Alto Medical Foundation (PAMF) planning to build a state-of-the-art hospital in either San Carlos or Redwood City, and Kaiser hospital tripling its size at its existing Redwood City site, will Sequoia be able to hold its own after it rebuilds its Alameda de las Pulgas campus?

"I don't know if the community can support three new hospitals," Sequoia Hospital's president, Glenna Vaskelis, said soon after PAMF announced its plans to move into the South County last spring. And that's a sentiment echoed widely throughout the health-care community and among public officials, including county Supervisor Jerry Hill, who organized a task force to study the issue.

The task force meets this week -- on Thursday, April 8 -- in a roundtable discussion with Sequoia Hospital and Sequoia Healthcare District officials to talk about possible scenarios for the future of the hospital. The public meeting begins at 7 p.m. in the Redwood City Library Community Room, 1044 Middlefield Road.

Owned by a partnership made up of the public health-care district and the private, nonprofit Catholic Healthcare West (CHW), Sequoia must be rebuilt to meet state-mandated seismic standards by 2013. Sequoia officials had planned to rebuild the facility on a new Redwood City site near the Bayshore Freeway, and was in the process of securing land last year. But that was before PAMF stunned the Sequoia community with its hospital plans.

Sequoia squeezed out?

Supervisor Hill, other public officials, and members of the medical community say that the public's access to health-care options in the area could be threatened with the planned expansion of PAMF/Sutter. One outspoken critic, Dr. Fred Marcus, called the PAMF plan a "hostile takeover" maneuver designed to "make Sequoia Hospital go away."

And if that happens, he noted, medical care for most of the county -- and certainly in the South County -- will be limited to Sutter Health and Kaiser, resulting in higher health-care costs to patients.

Dr. Marcus, the medical director for physician strategy at Sequoia Hospital, recently helped form a physicians alliance to give doctors affiliated with Sequoia clout to negotiate with insurance companies on health plans. He said negotiations have been going well. "Some health plans specifically said they want Sequoia to remain to give them some leverage" against Sutter, Dr. Marcus said.

The Sutter/PAMF facilities, now located mostly in Santa Clara County, are operated on a model similar to Kaiser, with group-practice physicians providing medical care. Sutter also operates Mills-Peninsula Hospital in Burlingame and San Mateo, now a community hospital whose patients are admitted mostly by independent physicians with private practices.

But doctors at Mills-Peninsula are now in talks with PAMF about possible collaboration in the future, leaving open the possibility that Sequoia might be the only hospital operating on the independent-physician model in the South and Central County -- if it survives what is likely to be fierce competition for patients and staff.

Dr. Marcus said limiting the practice of medical care to one model -- which could happen in the South County if Sequoia closes -- would take away patients' choice to "access their physicians on their own," and doctors' choices to practice medicine as they believe it should be practiced.

Under the group-physician model of medical practice, he said, there are requirements dictating how many patients a doctor must see and placing other "rigid controls" on medical care.

"Doctors who don't want to be part of Palo Alto (foundation's group practice) don't want to be for specific reasons," Dr. Marcus said. "There are some who say that the controls ... don't dilute the quality of care, and that they're necessary (to contain costs). But some of us disagree."

Dr. David Druker, who heads PAMF, has argued that the group-physician model his medical foundation embraces is the way of the future, both because it is more efficient and because younger doctors and medical professionals are more drawn to it. And in an era of doctor and nurse shortages, a group-practice health-care provider will be more successful in recruiting staff than those based on the independent-physician model, he said.

The San Mateo County task force studying the issue of hospital construction possibilities in the South County will meet on Thursday, April 8, at 7 p.m. in the Redwood City Library Community Room, 1044 Middlefield Road. For more information, call 363-4460.

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