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How Safety-Net Hospital Closings Affect PCPs

John Commins, for HealthLeaders Media, December 7, 2011

Closing a safety net hospital kicks up a significant ripple effect for primary care physicians and underscores the need to involve those providers in the planning and aftermath of such a disruptive process, a study has found.

The study -- Effect of Closure of a Local Safety-Net Hospital on Primary Care Physicians' Perceptions of Their Role in Patient Care– appears in Annals of Family Medicine. It examines the August 2007 closure of the 450-bed Martin Luther King Hospital in South Los Angeles, and interviews 42 primary care physicians who were affected.

"The primary care doctors were trying to figure out what they were going to do," study lead author Kara Odom Walker, MD, told HealthLeaders Media. "They were really frazzled by the whole upheaval and trying to deal with it the best way they could. There was a lot of rich conversation that did not make it into the study."

The study found that many of the primary care physicians complained of profound professional and personal upheaval owing to the disruption of the care network. "A lot of medicine is informal networks of care where you call your friend, your local gastroenterologist who has been there forever to see your patient in who needs to be seen sooner than later," Odom Walker says.

The disruptions included reduced access to specialty care, overcrowding at nearby hospitals and emergency departments, delayed and poorer quality of care for patients, reduced communication and disrupted patient connections, and a loss of colleagues and opportunities to teach residents and medical students, the study reported.

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