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Columbia County CONned out of ERs

Posted: January 30, 2013 - 12:02am

Congratulations, Columbia County. We’ve been CONned.

The Georgia Department of Community Health on Friday denied permission for Doctors Hospital and University Hospital to build freestanding emergency rooms in Columbia County.

While not entirely unexpected – the DCH has never allowed anyone in Georgia to build a freestanding emergency room – it still stinks. It means fast-growing Columbia County will continue to rely on long rides to the next county for emergency medical care.

It’s also bad news for outlying counties, such as Lincoln and McDuffie, that could have benefited from having an ER closer to them. Now their best hope will continue to be the fact that Gold Cross has a helicopter ambulance, or that Doctors and/or University prevail with their appeals of the rejection.

If the applications had been approved, Doctors would have purchased land adjacent to Marshall Square where they would have built a $9.8 million, 12-bed facility with a trauma room. University planned to build a $9.67 million, 18-bed facility with five trauma rooms at its existing Evans campus on North Belair Road (at what soon will have a direct connection to River Watch Parkway).

Instead, the DCH rejected the two hospitals’ separate requests for Certificates of Need to allow them to build the facilities. Columbia County gets exactly zip, thanks to the DCH. And it all begs the question: Why do we have to go to Atlanta for permission to build a medical facility in the first place?

It’s shouldn’t be a surprise that the initials for the certificates spell CON, because that’s what we’ve gotten. We’ve been conned out of allowing the free market and consumer demand to determine where and when to build medical facilities.

You don’t see that anywhere else. Just imagine if you had to receive state approval before you could build another restaurant in a community, or another gas station, or another grocery store.

“But,” the less-enlightened might say, “we’ve got tons of restaurants, gas stations and grocery stores! Maybe someone should decide how many is enough!”

“Someone” does: The investors. They put their money at risk and decide what to build, and where, and when. If they succeed, they make money. If they fail, they lose money. But in either case, it’s their money and how they spend it should be their decision.

But in the medical industry? Nope – the DCH gets to decide whether your community “needs” an MRI machine or an emergency facility. The defenders of this anti-free-market process claim that it’s to keep a community from being overloaded with more facilities than it needs, but so far the free market seems to do a pretty good job of that with everything else. What makes medical care so special that it gets to operate outside the free market?

Of course, it shouldn’t go without saying that there is just a hint of irony to this rejection. If you recall, just a few years ago the Medical College of Georgia (that was actually its name at the time) received DCH approval for a medical facility near Riverwood Plantation.
Almost immediately, MCG’s plans were delayed because of legal challenges – from University and Doctors hospitals.

With their restructuring, MCG has since abandoned its plan. That’s a real shame, because it eventually could have become a full-blown hospital closer to the center of the county and nearer those outlyng counties. And now, thanks to the DCH, we aren’t getting the facilities that University or Doctors wanted to build, either.

Enjoy your ambulance rides. At least the Gold Cross folks are friendly.

(Barry L. Paschal is publisher of The Columbia County News-Times. Email barry.paschal@newstimesonline.com, or call 706-868-1222, ext. 106. Follow at www.twitter.com/barrypaschal.)

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Comments (5)


Stand Alone ER is Dangerous

A stand alone ER without a hospital with specialty care is inadequate, even dangerous in some ways. As the population has grown Columbia County has earned a full hospital with an ER. It will be a money maker for the hospital and provide a needed service for the county. I'm hoping Doctors or Trinity build a HOSPITAL in the county.


How much medical security is enough?

If the hospital is built in Evans (towne), the center of the county, what of the folks in Harlem? Or Appling? Does everyone get to be close enough to a hospital to save every life? There is a greater issue involved in this situation. Man on the street interviews are saying yes I would like to have a hospital very near my home. Who decides which citizens are provided with life assurance plans? We could have a hospital, drug store, doctor s office and clinic in every strip mall. Would that bring peace of mind to the concerned.

We are feed a constant shopping list of things "WE NEED" that involve more construction, more taxes, more government control. We live in a society of "WE NEED".

Once large trauma center type ambulances were sold as the answer to remote patients living or dying. EMT's. How many ambulances? Where are they located? Do they have defibrillators? Then it helicopter med evac.

Look at the less populated counties in the CSRA. Hospitals closing, reduced services because of "none use". Looking to UH or MCG to build satellites. Where are these critical patients going today?

Obama and the Queen of England have private personal medical faculties at the discretion. Does we have that constitutional right as well? Life, liberty and the pursuit of happiness may be a fully equipped empty hospital next door to our planned community, just for our emergencies.

And if the answer is, well if it was your life? The question might be, are you spiritually prepared to die?

If you are in constant critical need of a hospital next to your home, maybe you should move next to a hospital.

Sweet son

Also it should be noted that Gold Cross doesn't have a

monopoly on the air ambulance business in the CSRA. Nothing says that the Gold Cross ambulance will be available at all times. Just remember that a second air ambulance based at Daniel Field is also available and would run first in or back up which ever is necessary. Just because the helicopter has MCG or whatever Azzix says posted on the exterior does not mean that it is their exclusive air ambulance. I suspect if you checked with any of the flight crew members they would say that they are available to save lives!!

Little Lamb


Wednesday's Chronicle editorial has a slightly different slant than Barry's column here in the News-Times. They wanted the stand-alone ER because ERs are more profitable than other aspects of full-service hospitals. Here is a cut-&-paste from the Chronicle:

. . . while hospitals can try to make ends meet with more profitable emergency operations. It’s particularly outrageous that in Georgia, the government is starving traditional hospital operations with drastically reduced reimbursement rates – while denying them the opportunity to make a little money with emergency rooms.

It sounds like University and Doctors are trying to get the public to mis-use emergency rooms to treat non-emergency medical situations because the re-imbursement rates are higher. I'm not particularly surprised, but it is a bit of a disappointment that the medical profession is encouraging improper use of resources.


Consider Trauma Centers

Consider how trauma centers are designated and realize a stand alone emergency room would be at the bottom of the barrel. If you had a life threatening emergency you would want to go somewhere with full specialty care. If you are talking simply being seen for the flu or something you should go to one of the many urgent care clinics in the area. In most cases, there's no way an EMT can decide who needs a hospital and who doesn't.