Memorial facing deadline to replace neurosurgeons

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If Memorial Health System can’t find neurosurgeons to replace the doctors who ended their contract with the hospital July 30, it could be at risk of losing its status as a Level II trauma center.

Randy Kuykendall, chief of the emergency medical and trauma services section for the state health department, said the hospital has until Aug. 18 to present a plan to correct the problem.

“Department rules say that a hospital has 15 days to submit a plan of correction to the department,” he said. “This is a significantly important issue and neurological care is one of the differences between a Level II and a Level III designation. They have to have a plan to get that care back in place.”

The plan has to “demonstrably prove” the steps taken to fix the problem, as well as to keep it from happening again.

“We’ve been extremely involved in the situation,” Kuykendall said. “We’ve worked with the ambulances, and with Penrose-St. Francis to make sure that the needed care is available until this can be fixed. The region is set up that both hospitals are needed at a Level II designation to provide the care.”

Memorial says it plans to have at least three neurosurgeons in place by Sept. 1.

“We’re in talks with a number of doctors,” said Manoj Pawar, chief medical officer for the hospital system. “Some of them come from the same practice (Colorado Springs Neurological Associates) that left. They approached us and said they were still interested.”

Pawar said hospital administrators met with state officials Monday, and that the state was “very supportive” of the system maintaining its Level II trauma status.

“They recognize the amount of care we provide in southern Colorado,” he said of the state’s busiest emergency room. “And they know we’re working on getting the spots filled.”

Kuykendall said three on-call neurosurgeons could provide coverage, but that “it probably isn’t sustainable in the long-run.”

“To earn Level II, hospitals have to show they have coverage 24-seven, 365 days at a sustainable rate,” he said. “Neurosurgeons don’t have to be in the hospital, but they do have to be within a generally acceptable time frame. Usually, that’s 30 to 60 minutes.”

Pawar declined to say where the additional neurological surgeons will come from, but he did say at least one doctor is from the Denver area. There are only two other neurosurgeons not associated with Colorado Springs Neurological Associates in El Paso County.

The hospital views the loss of the contract as an “opportunity,” he said.

“We’re doing an analysis of what the community needs right now,” he said. “And as we discuss new services, the analytics change. We’re looking to see what we’re going to need in the long term.”

The hospital system is sending trauma patients to Penrose-St. Francis Health Centers, which also has a contract with Colorado Springs Neurological Associates. Five doctors provide the needed neurosurgical treatment there.

Neurosurgical care is one of the harder specialties to fill. Only 70 doctors complete the specialty every year in the United States.

“They are hard to come by,” Kuykendall said. “In fact, it’s why many hospitals in the rural areas stay at a Level III — they just can get the neurosurgeons.”

Irreconcilable differences

Andrew Staphopulos, attorney for Colorado Springs Neurological Associates, said the group terminated its agreement because of “issues we had tried to work out with hospital administration.”

“These issues were not related to compensation, or to insurance,” he said. “We were resolved to work them out, and termination was only a last resort.”

Staphopulos declined to cite specific problems with the hospital.

“I don’t want to air our grievances in the paper,” he said. “But they were significant enough to terminate our on-call coverage agreement.”

Colorado Springs Neurological Associates had served as on-call providers of neurosurgical care to Memorial for the past 50 years, he said.

“They’ve demonstrated their commitment to the community,” Staphopulos said. “And they are still committed. We still hope to work this out. We were in talks with the hospital right up until the end of the contract.”