How Safety-Net Hospital Closings Affect PCPs

"The usual way of doing business was completely disrupted and patients were confused," Odom Walker says. "It wasn't that their doctors' doors were closed, but patients felt like 'Oh my goodness what should I do next?' They were showing up with more acute issues at their physicians' offices or running out of medicines because a lot of these patients go to the emergency room and use it to refill prescriptions."

The study calls for greater input and participation from primary care physicians when a major disruption such as hospital closures loom in a healthcare delivery system.

"When a hospital closes or downsizes they really do need to think more about what happens to the primary care doctors because oftentimes they are not at the table," Odom Walker says. "Primary care doctors really know what is happening at the ground level but they are too busy seeing patients and keeping the doors open on their hamster wheel. They do experience the impact and they need to know what alternative strategies are available to get patients into care."

Odom Walker says she was not surprised to hear about the disruption within the MLK service area. However, she was surprised to learn that physicians from outside of the service area also were impacted by the hospital's closure.

"This was a safety-net hospital where mostly uninsured patients went. So you wouldn't expect private-pay patients and physicians who are mostly serving insured populations to be affected, but there is a ripple effect," she says.