ECRMC pediatrics and obstetrics units reopen, ending bypass.

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EL CENTRO, Calif. –  El Centro Regional Medical Center has reinstated its obstetrics and pediatrics units to operational status. Patients are no longer being diverted to alternate institutions and can expect to receive the same high quality care they have in the past, without compromises. While the immediate solution is temporary, hospital administration is actively pursuing a new direction for permanent medical staffing of the pediatrics unit.

The contract for the existing pediatrician’s group expired in February and was extended due to ongoing negotiations. Although ECRMC has worked diligently to resolve the impasse, the local pediatrician’s group has rejected the fair market value offer and decided to discontinue seeing new and unassigned patients at the hospital. “For our local pediatricians to make themselves unavailable to those in need is a very unfortunate situation for this community,” said David Green, CEO of ECRMC. “Nonetheless, we are dedicated to providing the best quality care available – even if that requires an alternative solution,” he added.

Prior to negotiations, the rate paid to these physicians was in fact higher for on-call pediatrics. This higher rate was due to the additional need for a Neonatal Intensive Care Unit (NICU) staffed by a NeoNatologist. While the hospital worked on a permanent staffing solution, the pediatricians were offered a temporary fee increase for being on-call in order to cover those specialized services and the increased liability for doing so.

Over the past three years, ECRMC has seen a sharp decline in NICU patients and the need for such services locally. This trend is due partly to a program partnership with the March of Dimes that began in 2010 to decrease the number of premature births in Imperial County. With the help of local Obstetricians and nurses the program proved to be so successful it dramatically reduced the hospital’s NICU numbers. The average census fell from 3.4 patients per day to only 0.3 per day, as of 2011. Meaning permanent staffing for the NICU was no longer a viable.

“The NICU support was necessary a few years ago,” said David Green. “We understood the physicians’ position at that time. However, ECRMC no longer maintains a full-time NICU as the community no longer has the same needs.”

The pediatrics unit also incurred a decline in average census in the past year in large part due to the excellent care of the pediatricians in managing their asthma patients combined with the hospital’s own asthma program which educates the public regarding how to care for asthmatic children. The average daily census in the pediatric unit declined to 0.2 in 2011.

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While observing these dramatic decreases in demand, ECRMC administration contracted with an outside agency to investigate the fair market value for essential services at the hospital. The proposed amount reflects the results of their unbiased third-party evaluation, which ECRMC is obligated by law to adhere to.

To determine the fair Market value, they take into consideration the demand and average time based on volume it takes to do the job and the average salary that the individual would be paid in a demographic region. In the case of the local pediatricians, the study determined that physicians can be paid approximately $150 per hour for time actually worked. Averaging it out to a daily fee that enables them to also be paid for coverage if not called at all. The current volume justifies a maximum rate of $450 per day.

“On-call” pay provides medical coverage for newborn and pediatric patients who have no relationship with a physician. On-call fees are intended to reimburse physicians for their inconvenience and time to cover unassigned patients visiting to the hospital. ECRMC currently services between 14 and 18 unassigned cases per month out of approximately 1,500 deliveries. The $450 rate is paid to physicians so they can be available for patients without an existing pediatrician. The physicians are paid the full amount whether they see patients or not. If a physician was on-call for a full 30 days they would receive compensation averaging $13,500 per month. That’s in addition to seeing their existing patients, which they are able to bill separately for.

ECRMC administration anticipates making an amicable agreement with reasonable individuals to resolve the need for coverage of unassigned pediatric patients visiting the hospital. ECRMC is here to serve the community by providing the highest quality care available and to do so within the prescribed rules, regulations and laws governing it.