When California's infamous rolling power blackouts hit Parkview Imaging Open MRI in Santa Monica, Calif., in May, one patient was on the table undergoing a biopsy and several others were receiving spinals to treat chronic pain. Dim emergency lights in the physician-owned center's basement suite provided just enough illumination to get the patients moved upstairs, where staff discovered that the air conditioning unit and chillers had been knocked out, too.
It took manager Carmelita Joyce four days to input all the data lost when the computers crashed. Regular transcription, scheduling and other business functions were stalled while she updated patient records.
"We ended up losing quite a few patients," Joyce says. "And a lot of them blamed us, asking, 'Why didn't you tell me this might happen?"'
With predictions of more rolling outages this summer, many California medical groups are preparing to minimize the impact of power loss on their patients and businesses. Blackouts were ordered on six days in January, March and May. But some offices say they don't fully understand the magnitude of the problem, and even obvious precautionary measures--installing backup generators or scheduling procedures for off-peak hours--are not always feasible.
"Unfortunately, the city of Santa Monica won't allow us to put a special generator out in the parking lot unless it works for the whole building," Joyce says. Because a majority of Parkview's regular patients like to be treated early in the morning, Joyce says creative scheduling must take a back seat to patient preference.
He hasn't been hit yet, but radiologist Jerome Gold, M.D., co-owner of MRI Centers in Torrance, Calif., agrees that the major impact of rolling blackouts for him would be the inability to scan patients and the subsequent loss of business. Gold says he investigated an alternative source of power but learned it was impractical to install a backup micro-turbine for his facility.
"You can't do it for one medical office suite without incorporating the whole building," he says. Bringing in other tenants and the landlord made the project too large and unwieldy. Logistical problems related to size, location and permits required for the turbine did not allow MRI Centers to take quick action.
With between $750,000 and $1 million worth of scanning and computer equipment at risk, Gold says the next consideration had to be protecting that investment.
"The major threat is power spikes," Gold says. "An abrupt shutdown could cause us to lose data, but the greater risk is when the power comes back on. It can cause significant damage to the major components of the system.
"The most prudent thing for us was to simultaneously protect our computers from crashes and our equipment from power surges," Gold says. "Under the advice of our service engineers, we went with high-grade surge protectors that have done their job. Of course, we don't know what would have happened if we didn't do that."
The surge protection cost about $10,000, Gold says, which was spread out over time by renegotiating MRI Centers' service contract.
Uncertainty about how the energy crisis will impact their practices plagues many California doctors, says Lawrence Kneisly, M.D., a neurologist in Torrance with a two-physician practice. He believes the state government and the utilities have failed to adequately inform the public about the true nature of the problem or what steps can be taken to prevent catastrophe.
"I get the feeling we are being treated like children," Kneisly says. "Elected officials are saying, 'Don't worry about a thing; we've got it under control.' But why isn't everybody part of the discussion to find a solution? I started wondering, 'What are the doctors doing?"'
Kneisly helped coordinate a late-June meeting, co-hosted by the Los Angeles County Medical Association and other providers, that brought together power suppliers, political analysts and healthcare organizations to discuss how to cope with the energy crisis. Earlier in the month, the California Medical Association notified its 35,000 members about a June 15 deadline for applying to the California Public Utilities Commission for blackout exemptions.
Some 9,500 businesses, including Parkview Imaging, completed the 10-page application for status as "essential use customers." While Joyce is hopeful her center will qualify, CPUC senior engineer Laura Martin says only 10% of the summer peak load is available for these exemptions. Hospitals are currently exempt, but until the final decision is made on Aug. 2, many applicants remain vulnerable.