SFist: Still a Hella (Ella Ella) Good Fight Over a Helipad

sfist_anon

Sat, 29 Dec 2007 00:05:32 -0800

I am a physician who works in a busy ER no in the Bay Area. I am not affiliated with UCSF or SFGH. 1. SFGH is the only level I trauma center in the Bay Area. I and most of my colleagues would agree that it is the best place to send a major trauma patient in the area (this includes Stanford Med Ctr). 2. The smaller, private hospitals (e.g. John Muir) mentioned in the above posts do not have the capacity to deal with serious trauma in the same way that SFGH does. The nursing staff are not well equipped or accustomed to dealing with serious trauma; they may not have a thoracic surgeon or neurosurgeon on call; in many cases these smaller hospitals do not even have enough blood on hand to staunch a serious hemorrhage. 3. I agree that the patients who would benefit most are those who are injured outside San Francisco. But doesn't everyone take day trips out of the city? This decision affects all of you. 4. I live two blocks from a busy hospital helipad. I actually think the ambulance sirens are much more intrusive. In fact I barely notice the helicopters any more. When I do I know some poor sick kid is getting the best care available.

SFistJim

Sun, 28 Oct 2007 22:57:14 -0800

IMO, this is a black/white issue of NIMBYism. In that all the virulent opposition to giving physicians another tool to save lives comes from people who own property in fee simple absolute close to SFGH. Let's say 200 yards or less. If one lives in this NIMBY zone, one might wish to check ones self. Maybe these people will take a 5-figure hit in real estate valuation when the life flights start. O.K.

CRS

Sat, 27 Oct 2007 18:09:22 -0800

Yes, it is long; that's why I broke it up... I wanted folks to understand that this is not a black-and-white issue, but has many shades of grey to consider.

aj

Sat, 27 Oct 2007 15:48:17 -0800

1. These comments are way too long for a little blog like SFist. 2. What paying patient in his right mind would choose to go to SFGH?!

CRS

Sat, 27 Oct 2007 13:31:29 -0800

For all these reasons we know that SFGH cannot fulﬁll its mission to serve the poor of SF if it brings in more patients from Northern California. CONCLUSION Even if the private, paying patients from Northern California were to make money for SFGH it is not ETHICAL, PRACTICAL OR GOOD MEDICAL CARE to provide them care at the risk of delaying care to the poor of SF. It would be like telling parents of poor children in SF, “Your kids can’t go to school this year because we have to have our teachers teach private paying students from Walnut Creek… BUT next year your kids can come back to school (if we make enough money).”

CRS

Sat, 27 Oct 2007 13:31:14 -0800

4. We know that the SF Department of Public Health which is responsible for SFGH has many unmet medical needs and other priorities that are far more important than opening up City health services to residents of other counties. Some of those unmet priorities are: • SF has the highest rate of TB infection in the US. • SF has an extremely high murder rate. • Many of the siblings of victims of gang violence need medical/psychological help. • AIDS programs face decrease funding. • Inadequate drug treatment fuels our terrible homeless problem • DPH’s own disaster preparedness central command center and their ofﬁces at 101 Grove Street are not seismically retroﬁtted and they do not have adequate back-up generators, despite bonds already passed to fund all this work. (Civil Grand Jury Report 2007)

CRS

Sat, 27 Oct 2007 13:30:35 -0800

3. SFGH has not done (or not shared) any detailed analysis of the ﬁnancial or social impacts of expanding their medical services to the broader area of Northern California. We do, however, know the following: a.) We know that unlike the majority of Trauma Centers in the US, SFGH is its city’s only public hospital. SFGH’s stated mission is to care for the poor and the under-insured SF resident. b.) We know that for years SFGH has been seriously overcrowded, on diversion (sending patients to other facilities) about 20% of the time, and has been “over-census” almost every day. SFGH is budgeted for 302 beds a day, but typically has 320–350 inpatients a day (Dr Mitch Katz, 3/07, public meeting) c.) We know that there are very long waits for care in the SFGH Emergency Dept (ED) d.) We know that the hospital has written that the helipad patients will not require them to hire any more staff (2005 Initial Study) e.) We know that since the helipad project began, the City has created an insurance plan for poor SF residents the result of which is that there are now an additional 82,000 patients who will feel more empowered to seek medical care when they need it. While this is an excellent plan for the working poor in SF it will also contribute to the further stretching of the already limited resources at SFGH f.) We know that the new SFGH will not have more bed capacity than the current hospital. And as of 10/25/07 we know that SFGH will not have to be rebuilt before 2020. g.) We know that when SFGH is on diversion, patients are often sent to the only other hospital in the Eastern neighborhoods, St Luke’s. Sutter Health has published plans to radically change/limit their ED services by changing their inpatient facility into a number of outpatient clinics, leaving no inpatient services/backup for the treatment of patients in their ED. (SF Chronicle, 10/20/07)

CRS

Sat, 27 Oct 2007 13:29:17 -0800

2. The majority (92%) of the patients will be “tertiary referrals” “from the broader suburban and rural regions of Northern California.” These are patients who have been stabilized in other California hospitals, who have insurance and who are being referred to SFGH or other SF private hospitals for SCHEDULED, special/tertiary care. These are NOT accident-scene trauma victims. (From 2003 Needs and Feasibility Study, p. 3–14)

CRS

Sat, 27 Oct 2007 13:28:34 -0800

In response to andyc's question [21] concerning $$. It took a bit to marshall this, but here it is, broken into several parts as my 6 responses in Coments 3-8 above are. Financial costs/beneﬁts from proposed SFGH Helipad: 1. SFGH has said they will not be charging helicopter operators for the use of their helipad and that they don’t know if they will make any money from trauma victims who are ﬂown in. (This is because, typically, victims at the SCENE of an accident are not searched or asked for proof of medical insurance before being transported by ambulance or helicopter. This type of patient, however, is the smallest percentage of patients (8%) that will be transported by helicopter. (From 2005 SFGH Initial Study)

Belgand

Thu, 25 Oct 2007 00:34:58 -0800

First off, if this is an issue of "but it's too loud and it might crash!" go fuck yourself. This isn't a commercial airline flying overhead. It's for a hospital and is only being done with the intent of providing medical care. I mean, it's not so the doctors can save time on their commute or get lunch delivered or something. If you're going to bitch about it for some NIMBY reason the punishment is that you now have to live in Oakland. That'll learn 'ya. Now, as for whether the helipad should be built now, where it should be built exactly... these are valid concerns. At the same time they should not be presented in a vacuum where the only answer is "don't build it". We need a counter-plan for how we're going to have a helipad presented as well. Maybe it'll be nearby and shared between facilities, maybe now isn't the right time to build it and a temporary solution needs to be put forward until the seismic upgrade so we aren't just wasting money for a short-term solution.

sangfroid826

Wed, 24 Oct 2007 18:19:57 -0800

Well CRS, you've convinced me.

SFistJim

Tue, 23 Oct 2007 17:31:07 -0800

I live something like 5000 yards away from where the helipad will go in. The people that actively oppose it live much closer. I'm not here to argue with them. The intense opposition has 100% to do with noise, IMO. All the arguments are on the helipad website, so check it out if you want.

andyc

Tue, 23 Oct 2007 17:19:32 -0800

CRS makes some convincing points. sorry, "a helicopter blade will come through my window" immediately made me think this issue was just like the anti-blue angels rhetoric ... "they are sooo noisy and they frighten my vegan cat and put my chakras out of alignment and the city will be destroyed by plane crashes even though an earthquake or getting shot in the mission is 100x more likely " . so thanks CRS for actually giving some serious food for thought about the issue. now here is a follow up question. you mention that "The influx of paying patients covered by insurance will adversely affect those who are medically indigent".... what i don't get, is how does the hospital pay for the indigents if they don't take insured patients from time to time? wouldn't a hospital's long-term survivability be dependent somewhat on having regular patients as well? or is their funding from a different source that lets them continue their mission of 'safety net' stuff. is the hospital wanting this helipad because it will be a cash cow for them?? who does it benefit?

haplito

Tue, 23 Oct 2007 17:12:34 -0800

"dummy" is the new hella. Get used to it.

SanFranCitizen

Tue, 23 Oct 2007 16:39:14 -0800

Hey SFistJim - CRS presents good points. If you're so in favor of the helipad, why don't you refute his remarks?

CRS

Tue, 23 Oct 2007 16:37:27 -0800

Helipad poll doesn't fly San Francisco Business Times Regarding your recent Bay Area Business Poll "Do you think San Francisco General should have a helipad?": Did you know that UCSF Mission Bay has an already approved helipad to be built within one mile of SFGH? Did you know that SFGH wants the helipad before they are to be seismically upgraded? Did you know that there are several unused helipads in San Francisco? Did you know that SFGH's proposed helipad will not serve anyone within San Francisco? Did you know that based on its own study 93 percent of the flights will not be acute-care emergencies? Did you know that within a one-mile radius of SFGH there are 17,000 children pre-K-12 grade in public and private programs/schools with outdoor areas -- not including the infants/toddlers cared for at nearby homes? Well, no one else reading your introduction to the poll will know this either, because you've chosen to write it in such a biased, narrow-focused manner. I'm shocked, and saddened by this type of journalism. Elain Sprague / By email

mariconsoy

Tue, 23 Oct 2007 16:37:11 -0800

It does make sense to build a helipad on top of a building that will be torn down due to seismic issues. We have so much money after all. There will be one minutes away at Mission Bay. Why do we need two, when we've lived life without even one?

SFistJim

Tue, 23 Oct 2007 16:25:04 -0800

Build the UCSF one also, that's fine. For the keiki. Now back to SFGH. The polling shows an 84% to 16% vote in favor of building. http://www.bizjournals.com/sanfrancisco/poll/?poll_id=3423 http://sanfrancisco.bizjournals.com/sanfrancisco/stories/2006/03/13/editorial1.html?page=1 "The fact is, Potrero and other hospital environs are part of a vibrant urban neighborhood, not a bucolic rural preserve. S.F. General's ambulance sirens are frequent and U.S. 101 hums nearby amid the audible hustle and bustle of restaurants, bars and city life. It's part of the urban bargain, and in that context, three helicopters a day -- the agreed average for an SF General helipad -- are unlikely even to rise to the level of serious inconvenience. The benefits, however, might be measurable -- in saved lives."

CRS

Tue, 23 Oct 2007 16:14:42 -0800

Thank you, but still: Plan Potrero Hill isn't the outreach arm of either entity - neither UCSF nor SFGH.

SFistJim

Tue, 23 Oct 2007 16:14:34 -0800

Yes, the helipad is what most of SF wants. The Stop the Helipad person should find allies who don't live within 200 yards of SFGH. Those people will be hard to find, however. This isn't a neighborhood fight about how the Castro chased away their helipad and the Inner Sunset chased away another helipad, and now it's another area's turn. Those other decisions are in the past. The medical decision is to build it. It's going to get built. Some people live near SFGH and are perfectly fine with the pad. Good for them. http://missionsf.tribe.net/thread/779b3cb7-c662-442f-9136-bff2e217785c#3a0e51e5-1270-4346-b729-9b5d45935350

Jon

Tue, 23 Oct 2007 16:05:22 -0800

I fixed the story and my apologies for getting the hospitals mixed up. It looks like I picked a bad week to stop sniffing glue.

CRS

Tue, 23 Oct 2007 15:55:18 -0800

The big brou-ha-ha is over the helipad proposed at SFGH. (Not the one proposed for UCSF.) The SFGH Mission is to serve the people of the City & County of SF. This will change the Mission of SFGH from a City Hospital to a REGIONAL facility. The influx of paying patients covered by insurance will adversely affect those who are "medically indigent" (without medical insurance); more will be turned away (diverted) from SFGH to accommodate the paying customer/patient brought in by helicopter. Is this what SF wants?

CRS

Tue, 23 Oct 2007 15:45:07 -0800

It appears that Blogger Jon has the proposed helipad at UCSF and the proposed helipad at SFGH all mashed into one, when they are actually separate. - Plan Potrero Hill (linked in Blog as the SFGH community meetings) *isn't* the outreach arm of SFGH. It has nothing to do with SFGH, much less serving as the SFGH community meetings. - The article by Shipra Shukla on the UCSF webpage (linked in Blog as having come up with "proposals to alleviate concern") isn't about the SFGH helipad. It is about the UCSF helipad. Completely different kettle of fish. It is TWO helipads that are being proposed. One for UCSF Mission Bay and one for SFGH. It is easy to see how confusion can set in because SFGH campus and UCSF campus are very near one another, and the doctors at SFGH are UCSF docs.

SFistJim

Tue, 23 Oct 2007 15:44:35 -0800

How to become NIMBY: 1. Move next to a hospital. 2. Complain about the hospital. Is Stop the Helipad a parody site? Seriously. It's a big fat joke to anyone who is not a member of the Potrero Hill whatever whatever. Lives of people who reside in S.F. are worth more than lives of those who live outside? That's what some appear to think. The pad will assist "only" 50 or so trauma victims a year? That's the argument? Medical experts vs. attorneys. Who should win this one?

mariconsoy

Tue, 23 Oct 2007 15:38:45 -0800

Jeeze, I'm traumatized. CRS= Guru

CRS

Tue, 23 Oct 2007 15:16:42 -0800

6. The cost to build the helipad in now up to $5.76 Million. They also plan to DEMOLISH it in a few years and rebuild it on the new SFGH to be built on Potrero Avenue. SFGH is our only public hospital and it already cannot provide all the timely care needed. $6 million could provide more doctors and beds for the patients who are already waiting for care.

CRS

Tue, 23 Oct 2007 15:16:26 -0800

5. Other dense urban areas like NYC do not have helipads on their Trauma Centers or hospitals. Patients are flown to helipads on the river and transported to the Trauma Center by ground ambulance.

CRS

Tue, 23 Oct 2007 15:15:54 -0800

4. An SFGH helipad is not needed in case of emergency. The City already has identified 29 emergency landing sites located across the City and near all 10 SF hospitals. These can be used if any one of those hospitals needs to transfer a patient to another Bay Area hospital. They would also be used in case of a mass disaster such as an earthquake. This diversification of emergency resources is necessary as no one knows exactly where the next disaster might hit. The Bay Area Ferry System is being enlarged to respond to need for mass evacuations. 4.a. Recently, UCSF Mission Bay has announced that when their planned helipad is completed, it will be made available to the City for use in a disaster

CRS

Tue, 23 Oct 2007 15:15:25 -0800

3. There is no demonstrated need for trauma victims in other parts of the Bay Area to come to SFGH. Currently no Bay Area Trauma victim is more than 10 minutes by helicopter from a Trauma I or Trauma II hospital. (Trauma II Centers have the same level of clinical care as a Trauma I Center) For e.g., John Muir in Walnut Creek was just voted one of the top US hospitals, especially for spine and orthopedic care. SFGH was not even in the top 300. 3.a. SFGH is a Trauma I Center for pediatrics as well as adults.

CRS

Tue, 23 Oct 2007 15:14:49 -0800

2. 92% of the proposed 700 annual landings at SFGH are scheduled flights from another Bay Area hospital to SFGH. These are private patients going to UCSF for heart surgery or to Davies Hospital or other SF hospitals for special procedures. About 400 will stay at SFGH for scheduled surguries. 2.a. SFGH and its emergency department are already overcrowded and SF residents endure long waits for care. For every private patient flown in from another Bay Area hospital, the SF patients will have longer and longer waits for care. SFGH has said they will not be hiring more staff to care for the increased numbers of patients. 2.b. SFGH is the safety-net hospital for the poor and under insured in SF. It needs to focus its care on those patients. That is their Mission.

CRS

Tue, 23 Oct 2007 15:14:10 -0800

1. Because the medical helicopters are all based in Concord or Santa Rosa, helicopters will not be used to transport a patient who has a trauma or accident in and within San Francisco. Currently, ground ambulances in SF reach trauma victims in 4-10 minutes.

mariconsoy

Tue, 23 Oct 2007 14:58:00 -0800

Maybe it's because there is no place in SF that perople can be brought FROM to the hospital? Should they land on top of the Transamerica Building to pick up patients??? I'm already worried about blue ice dropping on me. I don't need to be terrified of a copter blade smashing through my window.

SFistJim

Tue, 23 Oct 2007 12:35:30 -0800

SFGH is still the only Level One Trauma Center in the U.S. without access to a helipad or heliport. Why is that?