Trying to create best free-standing E.D. possible


BY DR. CARL RAMSAY  |  There has been a considerable turmoil, pain and consternation during the past 19 months since the closing of St. Vincent’s Hospital. I have been fortunate to participate with a group of highly skilled professionals who were given the tremendous privilege to look beyond the present and instead focus on the future in collaboration with your community. Our task was to accept the reality (that another hospital will not be built) and identify the healthcare access challenges facing residents of the West Village.

The loss of access to local high-quality emergency healthcare for West Village residents is real. It is not just your opinion, it is fact. The study conducted by the City University of New York School of Public Health at Hunter College validated your concerns that it has been more difficult to obtain local access to healthcare since St. Vincent’s closing in April 2010. Many in the study’s focus groups worried about where to go for emergency care.

As a Lenox Hill Hospital emergency medicine physician, I have been extremely fortunate to work with my colleagues at the North Shore-Long Island Jewish Health System to develop a plan to open the Center for Comprehensive Care, to be located at the former Maritime Union Building (more commonly known as the O’Toole Building) on Seventh Ave. between 12th and 13th Sts. The Center, being developed at a cost of more than $110 million, will operate as a division of Lenox Hill Hospital.

Our planning activities have been intense and comprehensive. We take your needs seriously. While most of the focus has been on the free-standing emergency department that will anchor this neighborhood medical complex when it opens in 2014, the facility will also feature state-of-the-art imaging and ambulatory surgery services, as well as offices for physician practices, for which we expect doctors formerly affiliated with St. Vincent’s to be given preference. The goal is to restore and preserve the integrity of local community healthcare. We want to work with your current physician. If you don’t have a physician, we will help you to find one.

This Center is for you, your families and your fellow West Village residents. It will accept all patients, regardless of ability to pay. The North Shore-L.I.J. Health System maintains contracts with all major private and public insurers. In addition, we are proud to have one of the most progressive financial assistance programs in New York for underinsured and uninsured patients.

I have listened to expressions of concern at your community board hearings about the emergency department that we’re developing — concerns that I think are reasonable and understandable considering that a freestanding emergency department is a new concept to New Yorkers.

While none exist in the city of New York, there are more than 250 free-standing emergency departments throughout the country. Many successful models exist in New Jersey and Connecticut, some dating back to the early 1980s. Our group has looked at these models and taken it to the next level. Our emergency department will be similar to other hospital-based emergency departments in terms of staff and services, but we’ve taken it a step further: All of our emergency medicine physicians will be board certified, which is not always the case in many free-standing and community hospital emergency departments. Further, we are individually selecting our physician and nursing staff to help ensure that the clinicians treating you are highly skilled, experienced professionals.

Other concerns expressed at the community board meetings were focused on the lack of available hospital inpatient beds — there will be two holding beds on the premises. Our group’s mission was to work with the reality of no hospital availability. We were focused on forward progress. Did you know that between 70 to 80 percent of all patients presenting to an emergency department do not need hospitalization?

What about the patients who need hospitalization? Through established protocols basic to the training of all Fire Department of New York and private emergency medical technicians (E.M.T.’s), any patients requiring an ambulance transport to a specialized center would NOT be brought to a community hospital or our Center’s free-standing emergency department if their clinical condition indicated the need for care at a trauma center, or immediate cardiac or surgical intervention. However, in the event a patient does present to the Center’s emergency department with a stroke or heart attack, our emergency medicine specialists can use the Center’s advanced life support technologies to successfully evaluate and stabilize patients, and then transport them to the appropriate specialty referral hospital. An ambulance will be stationed at the Center in the event that a transport is necessary.

For patients requiring admission on a less-emergency basis, ambulance transport will also be provided. Our emergency department physician would contact your physician and coordinate transport to the requested hospital. For those patients who don’t have a doctor, we would provide an appropriate physician to care for your specific medical problem.

As noted, the majority of our emergency department patients will require treatment but not admission. Most of our adult and pediatric patients, as well as patients in need of psychiatric evaluation, will be able to be treated by our emergency department staff and released. Each and every patient will be provided with a comprehensive follow-up plan. In addition, we will provide patients requiring specialty care with 24-hour access to a specialist consultation, using Lenox Hill Hospital as well as the North Shore-L.I.J. physician network.

The Center and especially the emergency department will place emphasis on continuing to identify and understand the unique demographics of your community. We want to be your community partner. Many of our finest emergency medicine staff currently at Lenox Hill Hospital formerly worked in the St. Vincent’s emergency department. Several have expressed interest in working at the Center’s emergency department. When the Center opens in early 2014, you can expect to see us in your community, collaborating with you and your community-based physicians to provide the highest quality of care. You deserve that.

Ramsay MD, FACEP, is chairperson, Department of Emergency Medicine, Lenox Hill Hospital. He will be overseeing the free-standing emergency department at the planned Center for Comprehensive Care in the former St. Vincent’s Hospital O’Toole Building.

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