LAKE PLACID - Local doctors spoke out Wednesday night in support of Adirondack Health's plan to convert the around-the-clock emergency room at its Lake Placid hospital to a 12- or 16-hour urgent care center.
The second and final public meeting on the proposal drew a crowd of 130 people to the Lake Placid Center for the Arts. Like last week's session, it featured comments from many local residents who are concerned, and some who are angry, about losing what they feel is an important community lifeline.
"What has Lake Placid ever done to you that you want to see us lose our emergency room?" former North Elba Supervisor Shirley Seney asked of Stan Urban, chairman of Adirondack Health's board of trustees. "Actually, what you should do is you should hang your head in shame."
A large contingent of Adirondack Health employees, board members and local private practice physicians were also in the audience this time. Several spoke in favor of the proposal.
"You're not listening," Dr. Claude Roland, a local private practice surgeon, told the crowd. "To say that there's something nefarious here, that there's some plot, that there's something happening here to attack Lake Placid, that's not the case. You're not listening to the data. You're not listening to the fact that this organization is hemorrhaging money and in 10 years there may be no hospital."
"We have an emergency room where we see one person at night, and it's (losing) $500,000 (a year)," said Dr. Woods McCahill, who has worked at the Lake Placid hospital since 1980. "We can't afford that."
Earlier, Dr. Anthony Dowidowicz, Adirondack Health's emergency medical director, said a large majority of the area's local physicians support the change. Many feel it should have been made a long time ago, he said.
"For some, the Lake Placid ER was seen as a convenience we could no longer afford," Dowidowicz said. "For others, taking the sickest people to the Lake Placid emergency room represented an often catastrophic delay in giving definitive care. This is the right thing to do for the sickest patients.
"We understand this is an emotional issue," Dowidowicz added. "But your physicians are deeply concerned about the overall health of the many communities we serve, and we're deeply troubled by the daunting financial challenges Adirondack Health is facing."
Not every medical professional in the audience was on board with the plan. Delina Fajardo, a physician assistant who works in both the Saranac Lake and Lake Placid ERs, said it will "change the culture" in the community.
"People need a couple of things for their certainty," she said. "They need a fire department, a police department, an emergency department and a school system. People do not move to an area, they do not come to visit as tourists unless they have certain things, and those are your things."
Other people shared their personal experiences with the Lake Placid ER. A woman who lives in Lake Placid, who didn't give her name, said her 3-year-old went into respiratory distress early Wednesday morning and she had to rush him to the Lake Placid ER. She noted that each Lake Placid rescue call would take longer if ambulances have to go to Saranac Lake, increasing the likelihood that both ambulances would be out if her child has that happen again.
Dr. John Broderick, Adirondack Health's chief medical officer, said there are other communities farther away from the Saranac Lake ER, like Tupper Lake and Long Lake, where ambulance agencies have worked out how to deal with such situations.
"This is something that we as a system and as an organization have to work out," he said.
As they did last week, Adirondack Health officials opened the meeting by talking about their financial losses, which were blamed on the "seismic shift" in health care toward home-based and preventative medicine, and a transition toward outpatient services.
Urban said Adirondack Health recorded operating losses of $1.5 million in 2011 and $3 million in 2012. It lost $1 million in the first quarter of this year. If nothing is done, Urban said the organization could "slide towards insolvency."
"We want to be here 10 years from now. We want to be here 20 years from now," said Adirondack Health CEO Chandler Ralph. "The fiscal pressures are coming so quickly that we have to respond them."
When an audience member asked what other areas the organization considered before targeting the Lake Placid ER, Urban said 40 other cost-saving or revenue generating efforts were reviewed.
"The reason why we continue to look at (the Lake Placid ER)," Urban said, "is because this is a viable option, if not the preferred option, because we do have an emergency room in Saranac Lake, as opposed to closing the (obstetrics unit), closing the primary care center in Keene, closing the primary care center in Tupper Lake, closing the dialysis unit. We didn't see viable options there, as opposed to the Lake Placid ER."
If money is the problem, Comfort Inn and Howard Johnson's owner Ron Butler suggested the town, village, the state Olympic Regional Development Authority and the Regional Office of Sustainable Tourism chip in to keep the Lake Placid ER going.
"We all have to be partners to solve this problem," Butler said. "We fund a golf course. Why not a 24-hour emergency room? We are helping National Sports Academy stay afloat. Why not support an ER in Lake Placid? If we save just one life, isn't it worth it?"
Adirondack Health's board is expected to vote on the ER conversion at its May 30 meeting. If it's approved, Ralph said it would be another three to four months of working with local ambulance squads and securing necessary state Health Department approvals before the change takes effect.
Town of North Elba Supervisor Roby Politi said after Wednesday's meeting that he expects the town and village boards will have a joint meeting soon to discuss the issue and draft a resolution to forward to Adirondack Health's board. He said he doesn't want to see Lake Placid lose its emergency room, but he understands Adirondack Health is in a difficult position.
Should the community lose 24-7 emergency room services, the town has an option to purchase the Lake Placid hospital property for $10. If that happens, Politi said it would be a "prudent decision" by the town to take over the property. Adirondack Health has already said it plans to move the services provided at AMC-Lake Placid to its nearby Uihlein Living Center nursing home campus.
"I think there are a lot of things that could be done with it," Politi said. "I'm speaking hypothetically, but certainly this community could use a community center, it could use a day-care center to help parents out, portions of the property could be utilized for grant monies that we have to develop athletic fields. We're not going to walk away from it."
Contact Chris Knight at 891-2600 ext. 24 or firstname.lastname@example.org.