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Closing Franklin Square pediatric units hurts Baltimore

MedStar Health last week announced the immediate closure of inpatient pediatrics and the pediatric emergency department at Franklin Square Medical Center, along with the abrupt dismissal of various staff members and the chairman of pediatrics, Dr. Scott Krugman, who has been at Franklin Square for almost 20 years and has been nationally recognized for his model of a combined pediatric emergency department and inpatient service.

Children seen in the general emergency department needing admission will be "transferred to the most appropriate care setting as we do currently for patients requiring pediatric intensive care," said an email sent to staff last week by Samuel E. Moskowitz, president of MedStar Franklin Square Medical Center and a senior vice president for MedStar Health. The email made no mention of the additional hours this will take, the additional cost of transporting these children and the additional inconvenience to parents and families with sick children.

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The pediatric emergency department saw approximately 17,000 visits last year, and the pediatric unit either admitted or held for observation about 850 children, all of whom will need to be transferred to other hospitals if they come to the Franklin Square emergency department now.

The email claims "outpatient pediatric surgery will continue to be performed on the MedStar Franklin Square campus with no disruption." But under this plan, children with a post-operative complication will need to be transported by ambulance to another hospital after hours, where their surgeon is not present and where their outpatient care providers are inaccessible.

In an era of "medicine as a business," it is extremely demoralizing to see the misuse of the medical system by people who appear to be more committed to financial issues than the stewardship of the hospitals they did not build but have been entrusted to oversee. They claim to be "not-for-profit," and they solicit philanthropy — like the $1 million former Ravens football player Todd Heap pledged to raise for the pediatrics unit, which is named after him — while at the same time discussing business decisions and quarterly profits. Medical care is a service, not a business. Other service providers, such as the police department, would not close homicide units and concentrate on the parking division because it produces more revenue (we hope).

It has taken years to build this pediatrics service, and it cannot be reactivated once it is dismantled and the need for it becomes even more obvious. We urgently request that all members of the MedStar board, but most particularly those who are actively involved in health care, hold the MedStar Health System accountable for the stewardship of the medical resources in our communities in a responsible way that provides the best care for patients.

These members include:

  • Rosie Allen Herring, the chief executive of United Way of the National Capital Area;
  • Dr. Christopher G. Kalhorn, associate professor of neurosurgery and director of epilepsy surgery, functional neurosurgery and pediatric neurosurgery at MedStar Georgetown University Hospital;
  • and Dr. Allen J. Taylor, chief of cardiology at MedStar Heart & Vascular Institute at MedStar Georgetown University Hospital and MedStar Washington Hospital Center.

This move is contrary to the MedStar mission statement, which reads; "To serve our patients, those who care for them, and our communities." This does not serve our patients, it expressly does not serve those who care for them who have been dismissed without warning or preparation, and it most certainly does not serve the community. The patients in the community will now need to travel to other emergency rooms if they wish to have pediatric emergency services, they will need to wait hours for their children to be transferred if they need admission and then travel to the hospital they are transferred to while trying to care for their families.

This is a decision that eliminates a service that was needed and heavily used by the community and was the life's work of doctors, nurses, philanthropists, managers, coordinators, community members and administrators. This decision did not improve any aspect of health care.

Dr. Glenn Treisman (glenn@jhmi.edu) is the the Eugene Meyer III Professor of Psychiatry and Medicine at the Johns Hopkins University School of Medicine. Dr. Joyce King is director of inpatient medicine for the MedStar Franklin Square Medical Center family medicine residency program.

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