The vital signs of (850) hospitals
Northwest Florida, the state’s last real frontier, has undergone a multitude of changes over the past decade. The population has grown, industry has blossomed, educational opportunities have expanded and, not surprisingly, local medical care provided by the region’s hospitals has evolved to where it is as good as anywhere in the state. Brick-and-mortar expansion of medical facilities, along with innovative and improved technology — and a focus on patient care and quality service sparked by a strong sense of competition — are the hallmarks of change in the region’s medical care.
The Doctors Are In Across Northwest Florida, hospitals are upgrading facilities and adding more specialized care as competition heats up. By Linda Kleindienst Originally published in the Aug/Sep 2010 issue of 850 Magazine
Walking into the new pediatric emergency room at Gulf Coast Medical Center in Panama City is like stepping into a scene from “Finding Nemo.”
Whales, dolphins, sharks and reef fish adorn the walls in the area’s first-of-its-kind ER for kids, a project that reflects the hospital’s focus on children and the demographics of Bay County, where more than one in five residents are under the age of 18.
Gulf Coast CEO Brian Baumgardner views the addition of pediatric emergency care as an enhancement of the special niche the hospital has established for itself within the local medical community.
“If you were born in Bay County in the last 20 years, most likely you were born at our hospital,” Baumgardner says. “Because of the relationship we’ve developed with families at the birth of their children, we’ve extended the opportunities for us to continue that relationship as their children get older.”
Crucial to that mission was the hiring of Dr. Michael Taylor, a specialist in pediatric surgery who only a few months ago performed the first robot-assisted surgery on a child in Northwest Florida.
“Gulf Coast has seen there is a need to develop a center of specialty for pediatric medicine, so they’ve taken and run with it. An example is the pediatric emergency room, where the children won’t be mixed in with all the hustle and bustle of adults,” says Taylor, pointing out that recent national studies have shown many emergency rooms aren’t properly equipped to handle the youngest patients.
Taylor, 38, a native of Chipley in Washington County who graduated from the University of Florida College of Medicine, knew he wanted to be a doctor when he was in high school. After getting his degree, he figured on practicing in a place like Miami or Pensacola. But then the opportunity came open in Panama City.
“When I first came here five years ago, I thought this was probably not the best place for me to work as a pediatric surgeon,” Taylor says. “However, I am busy, busy, busy. And with Gulf Coast trying to advance pediatric care, it makes me want to commit to stay here for a long, long time. I appreciate what they’re doing for the kids.”
Changing to Meet Growing Needs
Northwest Florida, the state’s last real frontier, has undergone a multitude of changes over the past decade.
The population has grown, industry has blossomed, educational opportunities have expanded and, not surprisingly, local medical care provided by the region’s hospitals has evolved to where it is as good as anywhere in the state.
Brick-and-mortar expansion, along with innovative and improved technology — and a focus on patient care and quality service sparked by a strong sense of competition — are the hallmarks of change in the region.
“We always have to be searching for where we can improve,” says Mark O’Bryant, president and CEO of Tallahassee Memorial HealthCare. “Our patients trust us with their lives. We have a moral obligation.”
Adds Dennis Taylor, CEO of West Florida Hospital, “There is nothing lacking within the Pensacola area except for highly specialized transplant services.”
Not only has growth in the industry brought high-wage jobs to the region, but the quality of medical care — and its availability — has aided with economic development and the creation of non-medical, high-wage opportunities.
Patients who once traveled hours to get specialized care now have more of it available it in their own backyard. From Pensacola to Tallahassee, hospitals are opening centers focused on the treatment of cancer and cardiac patients and providing improved obstetrics care for women and high-risk newborns. Several have purchased the da Vinci surgical system, a robotic and computer-assisted surgical device that allows doctors to perform minimally invasive surgery. Rural and smaller hospitals have established relations with their big-city counterparts and large medical groups for a variety of services ranging from X-ray readings to providing for visiting specialists. A good example is the new Sacred Heart Hospital on the Gulf, recently opened in Port St. Joe, which has teamed up with Tallahassee Orthopedic Clinic to provide surgeries.
Ron Gilliard, CEO of the nearly 50-year-old Calhoun/Liberty Hospital in Blountstown, credits a urologist who now holds office hours at the hospital every two weeks with saving his life by finding early indications of prostate cancer.
“We’re working aggressively to add to that specialist list,” Gilliard says.
As they have grown, many of the hospitals have tried to carve out a special niche in their regional market, an area where they can provide that extra measure of care that no one else can.
“Health care is such a dynamic industry,” says Steve Johnson, CEO of Bay Medical Center in Panama City. “From Pensacola to Tallahassee, everyone is trying to find their niche, finding a way to make it in an environment where the rules change almost monthly.”
In Bay County, Johnson’s nonprofit Bay Medical Center cares for more than 80 percent of the area’s heart cases. The hospital is ranked among the top 5 percent nationally for cardiac services and is on its way to becoming a Level II trauma care center, the only one between Tallahassee and Pensacola. Its competitor, Gulf Coast Medical Center, a privately owned hospital, cares for the lion’s share of pediatric and obstetrics cases and has the area’s only neonatal intensive care unit.
“To bring high-skill, high-wage jobs into the community, we have to have great health care,” says Gulf Coast Medical Center CEO Baumgardner. “We understand we have that role to fill.”
All of the region’s hospitals are waiting to determine the effects that national health-care reforms will have on the services they provide and, ultimately, their bottom line. In the meantime, of the patients they now see, about one in 10 have no insurance — and there is widespread recognition that those numbers could quickly grow, a financial repercussion of the Gulf oil disaster.
Despite the looming financial uncertainties, many of the hospitals are just finishing or starting major construction projects designed to meet the needs and demands of a growing region.
“We needed more operating-room and intensive-care unit capacity,” says Al Stubblefield, CEO of Baptist Health Care, which is headquartered in Pensacola and has embarked on a $30 million construction program at its main hospital labeled “Building a Better Baptist.”
“More and more of the patients who end up in the hospital are really, really sick. The acuity is up, which drives the need (for more capacity),” Stubblefield explains. “And we needed sort of a refreshing of the building. If you don’t have a sugar daddy and can get a new hospital, you need to spend some money and get a little makeover. We’re upgrading our rooms to modern standards.”
Bay Medical in Panama City is putting the finishing touches on a $70 million project, which includes 144 private rooms.
“With facilities, we were behind the curve going in,” says CEO Johnson. “We spent a large part of the last decade trying to get our infrastructure to where it can be competitive.”
West Florida in Pensacola has spent $84 million over the past eight years. Sacred Heart Health System, also based in Pensacola, just opened its new 25-bed, $38 million hospital in Port St. Joe — Sacred Heart Hospital on the Gulf — built on 20 acres donated by the St. Joe Foundation.
Capital Regional Medical Center only recently opened a 24-hour, seven-day emergency clinic at the site of Gadsden County’s old hospital, which has been closed for five years.
Only two blocks away from Tallahassee Memorial Hospital, which is developing a $200 million surgical/intensive care tower, a large construction site is the future home of a new cancer center, an outpatient surgical center and a training center being built by Tallahassee Community College to educate health-care workers — all set to open within months of each other. Dedicated space is also being set aside for health research to be done by Florida State University and Florida A&M University.
“It will be a broad-spectrum, multi-relationship campus, a unique medical environment,” O’Bryant says.
The Competitive Edge
Northwest Florida’s hospitals fall into two categories: nonprofit and for-profit. And the competition between them can be intense, as demonstrated by the back-and-forth in TV ads and on billboards.
The largest private provider in Northwest Florida is the Hospital Corporation of America (HCA), which owns West Florida in Pensacola, Gulf Coast in Panama City, Fort Walton Beach Medical Center, Capital Regional Medical Center in Tallahassee and Twin Cities Hospital in Niceville.
The HCA hospitals have been particularly aggressive in promoting their private rooms and their short emergency-room waiting times.
“We’re advertising so the public knows,” says Bud Wethington, president and CEO of Capital Regional Medical Center. “Competition between hospitals keeps us on the cutting edge of technology and services — and our patients are the beneficiaries. We help each other be better.”
For years, Capital Regional has promoted its private rooms to get patient attention. But Tallahassee Memorial CEO O’Bryant likes to point out that of the 770 rooms at his hospital, only 14 are semi-private — the rest are private. As for the ER waiting times, O’Bryant countered, “There is no measurement for that.”
But the most intense competition is in Pensacola, where West Florida, Baptist and Sacred Heart are located.
“It has been more or less pleasant, depending on where you fit,” says Baptist’s Stubblefield, adding that the hospitals in the area often collaborate. “We are considered one of the most competitive regions in the country. But that has also led to a lot of high-quality physicians and staff being attracted to our community.”
Laura Kaiser, CEO of the Sacred Heart Health System, says the area has turned into a “medical mecca,” adding, “I think the people of Northwest Florida are blessed by that.”
Where from Here?
As these hospitals finish their construction projects and meet the needs of the region’s growing population, what does the future hold?
Several of the region’s hospital CEOs see change on the horizon, with more physicians being directly employed by hospitals and greater collaboration and consolidation among those facilities that dot the 16 counties of Northwest Florida.
“We’ve already had 90 physicians join us, and we expect that to be over 100 by the end of the year,” Stubblefield says. “That’s a fairly significant seismic shift. They think they can more effectively meet the needs of the patients by becoming economically aligned with the hospital.”
Steven Johnson at Bay Medical expects that more hospitals will be consolidated into larger health systems.
“I’m not sure our current business model is sustainable,” he says. “I think most hospitals will become affiliated with a major system.”
Sacred Heart’s Kaiser says the hospitals especially need to ensure that they are able to meet the medical needs of the retiring baby boom generation.
“For boomers, and I am one, there will be a giant tsunami of us,” she says. “We have higher expectations, and I try to think a lot about that. How do we match demands with the needs and make sure we create something that is necessary and viable?”
Medical consumers can easily compare hospitals for volume, pricing and health outcomes on medical conditions and procedures — as well as mortality, infection and complication rates. Visit FloridaHealthFinder.gov, a website maintained by the Florida Agency for Health Care Administration, which regulates health-care facilities throughout the state.
County Health Rankings Chart
A 2010 report by the University of Wisconsin Population Health Institute ranked Florida’s 67 counties on how healthy they are.
Health Outcomes Where the 16 counties of Northwest Florida ranked when analyzing their citizens’ length and quality of life:
Santa Rosa 10th
Clinical Care Rankings How the 16 counties of Northwest Florida fared when analyzing their access to and quality of health care:
Santa Rosa 15th
Dr. James Andrews and The Andrews Institute
Repairing the sports stars of today, protecting the stars of tomorrow
It’s an image that haunts: University of West Virginia basketball star Da’Sean Butler, lying injured on a hardwood court with only minutes left in a 2010 NCAA Men’s Basketball Tournament semifinal game, his coach cradling his head as Butler’s tears flowed from the pain in his injured knee and visions of a promising professional career coming to an end.
Five days later, Butler was at the Andrews Institute in Gulf Breeze to undergo surgery and rehabilitation. Less than three months after that, he was selected by the Miami Heat in the NBA Draft.
Repairing injured basketball stars and NFL quarterbacks. Protecting the throwing arms of pre-teen baseball pitchers. Preparing college athletes to transition to the pros. It’s all in a day’s work at the Andrews Institute for Orthopaedics & Sports Medicine, a world-class sports treatment facility with 40 physicians and medical experts who specialize in treatment, research, training and sports injury prevention.
Built in 2007 by Baptist Health Care, which is headquartered only a few miles away in Pensacola,
the institute has created 150 local jobs and pays out an annual $10 million in wages.
But under the leadership of world-renowned orthopedic surgeon James Andrews — who himself has operated on a Who’s Who of the sports world during his career (Derek Jeter, Michael Jordan, Emmitt Smith, Tiger Woods) — the institute’s economic impact on the world of sports is hard to measure, as professional athletes come in the door seeking a cure for their injuries, then leave and see their careers (and often their teams) soar.
A recent example is Heisman Trophy winner Sam Bradford. The former Oklahoma Sooners quarterback was selected No. 1 in the 2010 NFL Draft, picked by the St. Louis Rams after undergoing shoulder surgery, rehabilitation and training at the Andrews Institute. There also is Los Angeles Dodgers outfielder Manny Ramirez, who is still wowing fans after spending two months at the Institute in 2009. Minnesota Vikings quarterback Brett Favre visited for arthroscopic surgery on his ankle in May to remove scar tissue and bone spurs — and at press time was still considering his playing options for the coming season.
On the international scene, after spending two months training at the Institute in Gulf Breeze, the Argentine rugby team took the 2007 World Cup by storm, finishing a surprising third.
And the Institute isn’t just working with the sports stars of today. There also is a focus on tomorrow, an example being the recruitment of local baseball-great wannabes, ages 9 to 18, for a study of the injury patterns in baseball pitchers to develop guidelines designed to keep players safe.
“One of our major focuses is growing the presence, the impact and the reach of the Andrews Institute,” says Al Stubblefield, CEO of Baptist Health Care. “The caliber and the quality of new physicians and specialists we’ve been able to bring to the market has far exceeded our expectations when we began the journey five years ago. This facility provides new opportunities for making Pensacola an attractive place to practice for high-quality physicians.”
— Linda Kleindienst Keeping It Local
Although money remains tight, one rural hospital is finding a way to serve its community.
Ask Ron Gilliard how it’s going at his hospital and he will candidly admit that it’s a daily struggle to survive. Those who run Northwest Florida’s handful of rural hospitals don’t have it easy. But in the case of the Calhoun/Liberty Hospital in Blountstown, the community has rallied to the cause, and the local nonprofit has been transformed from “not even a good Band-Aid station” into a facility that the region is proud to call its own.
“It has been a bit of a miracle,” says Gillard, the hospital’s chief executive officer, who at first had his doubts.
Of his introduction to the new job about three years ago, Gilliard remembers walking in the front door and being taken aback by the foul odor in the lobby and the worn, torn carpeting. The medical equipment was outdated and the rooms were run down.
The previous owner, the for-profit DasSee Community Health Systems of Quincy, had tried to shut it down. But the community wouldn’t let that happen. Business and political leaders — among them Laddie Williams, chairman of the hospital board, and local banker Vicki Montford — immediately stepped forward to fund loans, make donations and rally support.
Local families funded room renovations. The local chamber of commerce adopted the chapel. Wakulla Bank took on the lobby. The Rotary Club helped decorate the cafeteria, where it holds weekly meetings. There is even a chandelier in the room where women can now get breast-cancer screening. The clinical equipment has been updated. And the beds are new.
“We were starting from scratch,” says Gilliard, an Air Force veteran who previously worked at two small Georgia hospitals.
As for medical services, patients can now see a urologist without having to travel to Tallahassee, Panama City or Dothan, Ala. The hospital has just started providing endoscopic services, and about 250 CAT scans are done each month. A federal budget earmark is going to help renovate the emergency room.
While Gilliard will concede that the hospital is “still struggling,” there have been victories. The annual payroll is now more than $3 million, making the hospital one of the largest area employers. It has gone from losing money to making a $1 million profit in 2009.
“A hospital in a community this size is important,” Gilliard says. “But the biggest challenge for us is still financial, so we can upgrade and pay the light bill.”
And, by the way, hints Gilliard, there is still one in-patient room left to be adopted.
— Linda Kleindienst