By Gordon Woodworth, Chronicle News Editor
Glens Falls Pediatrics and Adirondack Pediatrics both have informed Glens Falls Hospital that they will no longer treat newborns, infants and children at the hospital after June 30, The Chronicle has learned.
Dr. Brian McDermott, the hospital’s senior vice president of clinical integration, confirmed, “In April, both practices informed us they would be resigning their privileges and no longer seeing patients at Glens Falls Hospital. They haven’t officially done that yet, but they have told us that is what they intend to do.”
Hudson Headwaters left to pick up the slack, for now; says short notice problematic
It would leave only Hudson Headwaters Health Network physicians seeing pediatric patients in the hospital, at least until the hospital can add pediatric “hospitalists.”
Hospital President and CEO Dianne Shugrue told The Chronicle the pending change is “a big challenge for the hospital, a significant challenge for us. This is not unusual in terms of what is happening nationally, but it is problematic for our community as we scramble to find more coverage.”
Dr. Socolof’s letter sounded an alert
The Chronicle’s awareness and pursuit of this story was triggered by a letter to the editor submitted by Hudson Headwaters pediatrician Dr. Elias Socolof.
Dr. Socolof wrote that “the ability on this short notice to obtain adequate pediatric coverage is questionable, and hiring locum tenens part-time or short-term physicians from out of the area to meet this need would be extremely expensive.”
Currently, physicians from Glens Falls Pediatrics, Adirondack Pediatrics and Hudson Headwaters Health Network all treat their own patients at the hospital and also share in treating “unassigned” patients who don’t have their own pediatrician.
National trend in pediatrics
Contacted for comment, Dr. Jim Fuchs of Adirondack Pediatrics said “what really precipitated the problem is our practices have been unable to recruit new doctors. We have interviewed some good doctors, but when they find out they have to work in the hospital, they take jobs elsewhere.”
Dr. Fuchs said the practices’ move to end their hospital role “is not without precedent. It’s what happened a decade or so ago when Glens Falls Hospital started hiring hospitalists. This is a trend that is happening all over the country in pediatrics. More and more young pediatricians are deciding to do one or the other: Work in an office practice or be a hospitalist.
“One-hundred percent of this is we’ve not been able to hire young doctors. It happened in adult medicine 20 years ago. It’s happening in pediatrics now.”
He said of Glens Falls Pediatrics and Adirondack Pediatrics, “I think we are all good people who do a good job treating patients and are just trying to keep our practices going.”
Messages left at Glens Falls Pediatrics for Dr. Guy Lehine and Dr. Richard Anderson had not been returned by press time.
Larson: ‘Short notice reprehensible’
Hudson Headwaters Chief Medical Officer Dr. Dan Larson said the move is understandable but leaves too little time to recruit more doctors to help fill the gap.
“It surprised me they would do it on such short notice…” he said. “I respect their decision, but the short notice is reprehensible. Our pediatricians would be incapable of doing all the calls. It would force our physicians into an impossible situation where they might burn out and then resign.”
He noted, “Irongate Family Practice pulled out of in-patient care about a decade ago, but they did it with adequate notice and planning.”
Dr. McDermott said it forces the hospital “to rearrange how we handle pediatric services. We are working with Hudson Headwaters to ensure quality care to the community. What that will ultimately look like is still being discussed.”
Asked about the timing, hospital Senior Vice-President Paul Scimeca said, “Well, it’s not ideal…It is what it is. The dialogue will continue to figure out the best plan for the hospital and the community.”
Hospital & HHHN cooperating
Hospital CEO Ms. Shugrue said it’s unclear how much it will cost the hospital to cover pediatric patients — “We have not run any numbers at this point,” she said — but said it’s a great example of the hospital working together with Hudson Headwaters.
“This is a significant burden on them as well,” she said. “In the midst of this challenge, Hudson Headwaters’ doctors could be saying we don’t want to go into the hospitals. They are no different from other pediatricians.
“Instead, they are stepping to the plate to work with us on a plan. It’s a great example of the two of us working together for the betterment of the community.”
The Hospital’s Dr. McDermott said, “We have all of the support services we need to handle deliveries. We are well equipped to deal with that safely, as we always have.”
Dr. Fuchs of Adirondack Pediatrics said, of the practice’s decision to exit the hospital, “Why now? I’m not a young man. I hope to retire in the next year or two. My partners are trying to replace me and have interviewed some really good candidates.”
Competing for the same doctors
Both Dr. Fuchs and Dr. Larson acknowledged that Hudson Headwaters and Adirondack Pediatrics recently competed to hire the same young pediatrician. He chose Hudson Headwaters.
Dr. Larson said Hudson Headwaters offered the opportunity to work technologically with medical records and data analysis, which was something “they can’t offer.”
Dr. Fuchs said “when we interview a good candidate that takes a job elsewhere, we do an exit interview of sorts to find out what was behind their decision.
“In this case, this particular doctor told us he loves to work with computers and they offered him one administrative day a week, which was attractive to him.”
Asked if exiting the hospital will hurt Adirondack Pediatrics, Dr. Fuchs said, “It doesn’t seem to hurt the pediatricians at the Community Care practice in Saratoga. They have a huge practice and they don’t go into the hospital down there.
“Many of their patients come up here to deliver [babies] at Glens Falls Hospital, and when they come in here and don’t have a pediatrician, we take care of them.
“Very rarely do they switch to us because we see them in the hospital…”
He said the positive side of the trend is “if all you do is work in the hospital, you get better dealing with sick kids all the time. And vice versa, if you are just in the office, you concentrate more on the problems children are having as outpatients.
“The downside is you like to see your own doctor when you go in the hospital.”
Dr. Fuchs noted that while Adirondack Pediatrics doesn’t have privileges at Saratoga Hospital, Glens Falls Pediatrics does.
Dr. Fuchs suggested that his colleague Dr. Florence Nolan was more involved in the practice’s decision process. She could not be reached by press time.
No change in timing after May 5 meeting
Pediatric groups that treat patients at Glens Falls Hospital had their regularly scheduled meeting on Tuesday morning, May 5.
Asked if anything notable happened, hospital Senior Vice President Paul Scimeca replied via email, “As expected at this morning’s meeting, we continued to discuss how to work to find a best solution for pediatric coverage for our patients and our community.”
Did Adirondack Pediatrics and Glens Falls Pediatrics indicate possible flexibility in their June 30 deadline to end their hospital role, Mr. Scimeca said, “In terms of their potential flexibility, that’s a question they would need to answer.”
Before the meeting, Dr. Jim Fuchs of Adirondack Pediatrics had told The Chronicle he thought his partners, and physicians from Glens Falls Pediatrics, would discuss the June 30th date at the meeting, “and they will be flexible on it.”
But Hudson Headwaters pediatrician Dr. Eugene McTiernan, contacted after the meeting, said, “It looks like the deadline of June 30th is still going to happen. They were going to bring it back to their partners but I don’t expect that to change.
“The next step is the hospital coming up with a plan to cover The Snuggery/nursery as a priority by July 1st. They are confident this will happen, so no disruption of obstetrical services is expected.
“The pediatricians and hospital will continue to meet regularly between now and then to make sure a good plan is in place, but there is much work to accomplish with such a short notice.”
— Gordon Woodworth
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