TALLAHASSEE — Lawyers and witnesses trudged along Thursday in a long-lasting, stop-and-go fight over just how many trauma centers Florida should have.
Administrative Law Judge R. Bruce McKibben resumed a hearing in a disagreement specifically over how the state Health Department OKs new centers, which have the specialized staff and equipment to treat severely injured patients.
In a nutshell, established health-care concerns don’t want to compete with newer kids on the block.
St. Joseph’s Hospital in Tampa, Tampa General Hospital, Bayfront Medical Center in St. Petersburg and UF Health Jacksonville have opposed new trauma centers, including at Regional Medical Center Bayonet Point in Hudson and Blake Medical Center in Manatee County.
Those in the windowless Tallahassee courtroom talked in terms of lives saved and medical ability, but the legal battle is just as much about the business of health care.
Trauma doctors and staff need a certain volume of patients, up to 1,000 yearly, to keep up their expertise and pay the bills.
“Existing trauma centers have a clear financial incentive to keep new hospitals out of the pool,” said a report last year by the American College of Surgeons on Florida’s trauma system.
The hospitals that operate older trauma centers say having more centers dilutes the pool of patients and also causes a strain on available medical specialists.
The newer centers, at hospitals affiliated with HCA, have responded that an increase in Florida’s residents and visitors justifies the need.
For instance, UF Health Shands Hospital in Gainesville has opposed the department’s decision to allow the trauma center at Ocala Regional Medical Center, an HCA health-care chain hospital.
Darwin Ang, medical director of the Ocala trauma center, testified that “there’s no perfect system out there but there needs to be an earnest effort to create something that’s reasonable.”
The current regulations, which allow up to 42 trauma centers across the state, are “definitely reasonable,” he added.
The Legislature in 2004 passed a measure that gave trauma centers a one-time infusion of $21 million and divided the state into 19 “trauma service areas.”
The number of trauma centers in Florida increased from 11 in 1992 to 27 this year, according to the Health Department, but several others have closed during those years for lack of funding.
Lawmakers even got involved again this year, crafting deals that would have essentially guaranteed the doors staying open at the Manatee, Marion and Pasco centers.
But those proposals got folded into larger health-care bills that died on the last day of session.
McKibben mentioned issuing a ruling in July, but related hearings with other parties will continue, meaning the issue could linger into 2015.