CRMC Contract Dispute Drags Into Labor Day Weekend, No Neurosurgical Services

It’s unclear if Community Regional Medical Center will have doctors to provide care for anyone suffering a head injury that requires surgery over the busy Labor Day weekend.

What is clear?

There’s still no agreement between the hospital and its physician provider — Central California Faculty Medical Group — to treat new neurotrauma patients. As a result, two neurotrauma patients were transported to hospitals in the Bay Area this week to receive medical treatment they would have otherwise received in Fresno.

Labor Day Weekend Trauma Cases in 2019

CCFMG compiled numbers from last year’s Labor Day Weekend for GV Wire℠ to offer perspective on how many neurotrauma patients might need treatment this year.

Ove the course of the three-day weekend last year, they had 47 trauma patients; 15 needed neurosurgical consults at CRMC.

Backup Staff Coming From Los Angeles

Friday afternoon, Fresno County EMS Director Dan Lynch was told by CRMC it will not have neurosurgical coverage heading into the weekend. The hospital is scrambling to bring surgeons from Southern California.

The lapse in coverage stems from a contract covering 28 physicians in 12 specialties that ended Monday. Six of these physicians are UCSF faculty who provide the 24-hour neurosurgical trauma coverage required for CRMC’s level 1 trauma center’s designation.

The doctors continued working, but CCFMG said that after 5 p.m. Wednesday patients with head trauma would be diverted to the nearest level 1 trauma center.

So far, there has been no reclassification of CRMC’s level 1 trauma center status, according to Lynch.

Community Medical Centers sent this statement to GV Wire℠ on Friday afternoon. “Both CCFMG and CMC are working diligently to resume neurosurgical trauma services as soon as possible.”

Lynch Expects Backup Staff to Arrive Over the Weekend

“They (CRMC) do have a number of individuals coming from the Los Angeles area that are going to fill those slots, and they’re working on processing them through,” said Lynch during a Friday afternoon Zoom call with reporters.

He expects them to arrive over the weekend, but they’ll need to be onboarded before they can start taking calls.

“A physician doesn’t just magically walk into a facility and start working right away,” Lynch said.

Lynch said that one patient was transported out of CRMC Thursday to Stanford Medical Center, and another patient was being transported Friday afternoon to UCSF in San Francisco.

Aside from neurosurgical staffing, Lynch said, “CRMC has all of the elements of their trauma center in place. The need for a neurosurgeon in most trauma cases isn’t there. However, when you need a neurosurgeon, you need a neurosurgeon.”

Trauma Center Designation

According to the American College of Surgeons, “the designation of trauma facilities is a geopolitical process by which empowered entities, government or otherwise, are authorized to designate.”

The ACS does not designate trauma centers, it verifies the presence of the resources listed. The ACS lists CRMC as a verified level 1 trauma center.

According to the American Trauma Society, elements of Level I Trauma Centers Include:

• 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial, pediatric and critical care.
• Referral resource for communities in nearby regions.
• Provides leadership in prevention and public education to surrounding communities.
• Provides continuing education of the trauma team members.
• Incorporates a comprehensive quality assessment program.
• Operates an organized teaching and research effort to help direct new innovations in trauma care.
• Program for substance abuse screening and patient intervention.
• Meets minimum requirement for annual volume of severely injured patients.