ER Medical
Director's Worries
My name is Marc Snyder. I am
the Medical Director of the St. Luke’s Hospital Emergency Department, where I
have worked for 25 years.
I have shared my written
testimony to the Board of Supervisors about the CPMC Master Plan with
Commissioner Guy regarding what I believe to be the negative effects on
emergency services at St. Luke’s and in the City.
I am concerned that a standby
ED will not receive ambulance patients, forcing ambulances to transport longer
distances. This will inevitably lead to delays in patient care and bad
outcomes. The stress on the pre-hospital system will be felt in increased rates
of ambulance diversion. Furthermore, some patients will misunderstand the
nature of a standby ED and arrive expecting the full services of an acute
hospital. They will find that limited care is available, and they may have to
wait considerable lengths of time before a transfer to an in-patient bed can be
arranged. Patients will end up at hospitals where their doctors don’t practice,
disrupting the doctor-patient relationship and continuity of care.
With the time constraints
today I want to ask 3 questions:
Is it fair and just to the
people of San Francisco that $1.7 billion dollars be spent on an acute care
hospital North of Market and zero for an acute care hospital South of Market?
Since St. Luke’s financial
condition can be explained by the uncompensated work we do taking care of the
indigent, and since the City receives State funding for indigent health care,
shouldn’t the City assume some responsibility for keeping St. Luke’s alive?
And lastly, what will you do
to keep St. Luke’s acute care open?
I believe that all the
parties –City and State government, CPMC, St. Luke’s, Sutter, SEIU, CNA – to
name the major stakeholders, should meet to develop solutions that would avert
the potential disaster of closing St. Luke’s in-patient services. It not done
soon, it will be too late for us all.
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