Commissioners Court: SA private hospitals adding trauma centers affect national security, economy

Methodist Hospital looking into opening Level II trauma center in San Antonio

SAN ANTONIO – The idea of private hospital systems in San Antonio adding Level II trauma centers has caused an outcry from public officials.

Now, the entire Bexar County Commissioners Court has publicly agreed with the San Antonio City Council and Brooke Army Medical Center leaders that the idea would be detrimental. 

Bexar County Judge Nelson Wolff and the commissioners all echoed two main concerns Friday.

University Hospital and San Antonio Military Medical Center are the only Level I trauma centers in San Antonio. A Level II trauma center has fewer qualifications than a Level I trauma center.

"We've seen in Austin where [a Level II trauma center] opened. It took 40 percent of the work away from Level I trauma centers, so it's a huge economic impact," Wolff said. 

Methodist Hospital said opening a Level II trauma center would offer the region more options.

Methodist Vice President of Marketing and Public Relations Palmira Arellano released the following statement:

"As the largest health system in the region that has a proven record of quality care, it is our obligation to perform a community health needs assessment and help provide resources to meet those needs. This includes the assessment and research of appropriate trauma levels in the San Antonio region. Our core competency of building partnerships in community led us to the first step in our research, which was to meet with BAMC officials to discuss the impact of adding a higher level of trauma care to our region and, to discuss any collaboration that may be considered in doing such."

In response, Brooke Army Medical Center said losing trauma patients to other hospitals would severely impact the economy and military medical training.

"To take the paying clients away would just add a tremendous financial burden to both operations," Wolff said.

Thursday, BAMC's top commander, Brig. Gen. Jeffrey Johnson, made a plea to the City Council. The following statement outlines that sentiment:

"Adding additional trauma centers to San Antonio presents a distinct threat to the medical readiness and training of DoD medicine. Any decrement in trauma patient volume erodes the unique position San Antonio has compared to other installations and puts at risk BAMC's current and future missions. It decreases quality of care as mortality rates of level 1 trauma centers are directly connected to volume or repetitions for the health professional team. The long relationship BAMC has with Southcentral Texas in caring for any person who unfortunately experiences a traumatic event could be disrupted especially looking at the integrated care for underserved populations served."

The City Council unanimously agreed, and Friday, the entire Commissioners Court did too.

Wolff met with Methodist administrators Friday morning and said he explained the move would have the biggest impact on national security.

"This is how they train their doctors, and if that volume goes down, they're not going to be able to treat as many wounds. They're not going to be able to prepare those doctors to take care of wounded soldiers," he said.

All four commissioners agreed. Precinct 3 Commissioner Kevin Wolff and Precinct 4 Commissioner Tommy Calvert offered KSAT further opinions.

"We are the training ground for all medical, for all military, so that's very important to us. Part of that training comes with the business that goes through those hospitals, BAMC being one of them, their Level I trauma center," Kevin Wolff said. 

"We must preserve the mission there at SAMMC because that is the largest economic development in the history of the county. It is two and a half times the economic impact of Toyota," Calvert said.

Calvert said in the future, the structure may need to be looked at again. 

"Bexar County is projected to grow by 1.5 million people over the next 20 years," he said, mentioning a time may come when other hospitals could step in without stepping on San Antonio Military Medical Center's toes. 

"Where the population is so much bigger that Methodist and SAMMC can coexist, I don’t know what point that is," he said. He said he doesn't believe that time has come yet. 

Commissioner Sergio "Chico" Rodriguez mentioned that millions of dollars were just spent to double the size of SAMMC's trauma tower and he believes it will accommodate a growing population. Rodriguez even plans to add an item to the next agenda, instructing staff to prepare an official resolution explaining the Commissioners Court's stance. 

In response to Methodist Hospital's ideas, Baptist Hospital reported Friday that it has no plan right now to build its own Level II trauma center. In a statement, spokesperson Patti Tanner said:

"Brook Army Medical Center’s Level 1 Trauma Center plays a vital role in providing expert care for the most critically injured in our community. We are grateful for the tremendous health care services BAMC provides, and continue to be supportive of the military training mission here in San Antonio.”

Nelson Wolff and Calvert are up for re-election. Nelson Wolff is being challenged by Tom Rickhoff. Calvert is running against Gerard Ponce.

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