Two of the three trauma centers in Pensacola, Fla., were forced to give up state certification last month after three neurosurgeons said they could no longer guarantee trauma coverage.
The loss of state trauma licenses means 484-bed Baptist Hospital and 389-bed Sacred Heart Hospital can only receive trauma cases from ambulances when 547-bed West Florida Regional Medical Center is overloaded.
Baptist and Sacred Heart continue to operate full-service emergency departments. But a doubling of trauma service cases to about eight to 10 per week has caused West Florida to consider dropping its trauma certification, a hospital spokesman said.
If that happens, the closest official trauma center in Florida would be either in Gainesville or Jacksonville, both more than 300 miles away. In practice, however, patients would be sent to the nearest emergency department.
The West Florida spokesman said the hospital will evaluate providing trauma services from a staffing and financial perspective over the next several weeks. West Florida is owned by Columbia/HCA Healthcare Corp., Louisville, Ky.
The problem began several weeks ago when three neurosurgeons notified Sacred Heart and Baptist of their staffing concerns, said Sister Irene Kraus, Sacred Heart's president and chief executive officer. The three physicians serve on the staffs of both facilities.
Sister Kraus said the physicians told her that they were becoming tired of the long hours after two years of providing primary neurological services. She said compensation for services was a minor issue.
The physicians, who were unavailable for comment, continue to hold privileges at Baptist and Sacred Heart and are on call for emergency services, as are other physicians on the medical staffs.
Sister Kraus said the physicians' decision led her to evaluate the efficacy of three trauma centers for a city with a population of 58,165. Her conclusion was that Pensacola doesn't need three trauma centers when there are only nine others in a state with a population of 14 million. Since 1986, 24 hospitals have dropped trauma center certification because of financial losses, liability concerns and staffing problems.
"The volume isn't there to support three trauma centers," she said. Last year, the hospitals shared 536 trauma cases. West Florida handled 240, Baptist had 182, and Sacred Heart had 114.
In a 1990 report, Florida officials recommended the state be organized into 19 regions with about 50 trauma centers. The state targeted Pensacola for two trauma centers with a maximum of three.
Sister Kraus said Florida's stringent requirements for trauma center staffing, facility and equipment promote good quality, but they're designed for university or urban settings. "The standards don't make sense in a small community," she said.
A task force will be formed with the other hospitals to discuss a long-range solution. Options include developing a separate program among the three hospitals or petitioning the state to change the trauma center criteria, Sister Kraus said.
Meanwhile, West Florida will proceed with plans to recruit a third neurosurgeon, said Bernard Grappe, the hospital's vice president of marketing.
"We are trying to evaluate the financial impact of keeping it open," Mr. Grappe said. He added that West Florida broke even financially last year on its trauma care.