Waiting...Waiting...Waiting Room

Karen Reyes felt alarmed last year when her 9-year-old grandson, Swift, asked her to take him to the doctor, because "you just don't ever hear a kid tell you that," she said. It was almost midnight; Swift had been sick for four days and he was running a high fever, so Reyes decided to take him to the hospital.

"We went to St. John's, and they put us in the lobby," she said, adding that they left four hours later with a prescription that cured Swift's fever. "I call it waiting in line to die."

Reyes' two grandchildren, who have Medicaid insurance, have been going to Oklahoma State University Medical Center downtown on W. 9th Street ever since that experience, and she doesn't want them to go anywhere else.

"I've had great responses with these people here," Reyes said. "They were real concerned, they were quick, responsive; they came right into the room. ...It's my favorite hospital. I would hate to see it get shut down."

Closure of the facility, however, is a very real possibility. The OSU College of Osteopathic Medicine announced in September that it would move its residency program -- which provides care for nearly 88 percent of the facility's patients -- to Saint Francis Health System by July. The OSU medical school had said for years that it was concerned about the long-term stability of OSU Medical Center, but the facility's chief executive officer, Earl Denning, said Nov. 13 that he did not know why the school ultimately decided to move the residency program. The spokeswoman for the medical school did not return calls.

Since OSU announced its plans to move the program, OSU Medical Center has been losing $2 million a month - losses, the center said, it cannot continue to absorb. A solution must be found by Dec. 1, Chief Executive Officer Earl Denning said, or Tulsa's entire health care system could face dire consequences. He pointed out that OSU Medical Center treats 11,000 inpatients each year and also sees 40,000 emergency room patients, including 5,000 who arrive by ambulance.

"If the [OSU Medical Center] hospital and emergency room are gone, those patients are going to end up in other [Tulsa] hospitals' emergency rooms ... and they're all busting at the seams," Denning said. "There would be people literally standing on the sidewalks waiting to get into area emergency rooms, and ambulances would be lined up on the street waiting to get into emergency rooms. Horrifying."

St. John Health System, where Swift experienced that long wait, wrote to Gov. Brad Henry on Nov. 12, agreeing that it could not handle the influx of patients.

"Tulsa's other medical facilities, many of which run at or near patient capacity for much of the year, are in no position to absorb 50,000 additional OSUMC patients, many of whom have no health insurance or are covered through Medicaid," the letter stated. "[T]he sick or injured in eastern Oklahoma may find there is no room at Tulsa hospitals, which may result in those most in need being sent to Oklahoma City, thereby preventing those in western Oklahoma from receiving the care they need."

St. John urged the state to establish a public trust to take ownership of OSU Medical Center, which is owned by Ardent Health Services, a for-profit organization that also owns Tulsa's Hillcrest Medical Center. Ardent has offered to donate OSU Medical Center for a nominal fee such as $1, though the facility's estimated value is between $140 million and $160 million. It has 363 beds and about 1,400 employees.

Denning and Tulsa Mayor Kathy Taylor also sent letters to Henry supporting a public trust, and Tulsa City Councilors Eric Gomez, David Patrick and Rick Westcott issued a joint press release asking the state legislature to provide funding. The state owns one hospital, Oklahoma University Medical Center in Oklahoma City.

Henry said his administration is trying to find a solution that will protect the residency program and benefit Tulsans. He added that the administration thought it had achieved that goal two years ago, when legislation established a partnership between OSU and Ardent.

"I applaud OSU President Burns Hargis and St. Francis Hospital for their leadership and collaboration in constructing a plan to save the residency program, but there are additional issues to address in Tulsa," Henry said in a prepared statement. "With that in mind, I will continue working with legislative leaders, Tulsa officials and all other interested parties to again craft a consensus proposal that preserves the OSU Medical School and benefits health consumers and the Tulsa community at large."

Tulsa's Poor Continue to Suffer

If tax dollars were used to support OSU Medical Center, it would be the only publicly funded hospital in the Tulsa area. The 53rd-largest metropolitan area in the country, Tulsa is the biggest community without a publicly funded hospital, according to a 2002 state Senate brief. Nationwide 1,111 of the 4,897 community hospitals registered with the American Hospital Association are funded by state or local governments.

"There have been many people, [including] the Hillcrest Medical Center [seeking public funding], and I have been working on it for two years, and to no avail," Denning said. "It's hard to garner political support statewide for a local issue."

OSU Medical Center needs $12 million a year from the state to stay fully operational, if the residency program stays, Denning said. It is unclear whether state funding would persuade OSU medical school to cancel the program's move to St. Francis. Without the residency program, OSU Medical Center would need at least $30 million in annual state funding just to stay open as an urgent-care clinic with no beds and no emergency room, Denning said.

If the state and the medical school agree to keep the residency program at OSU Medical Center, The George Kaiser Family Foundation will pitch in $20 million to pay for procedures at the hospital and for insurance premiums of OSU Medical Center Patients, foundation Executive Director Ken Levit said. Half of OSU Medical Center's patients are "uninsured or underinsured," according Denning: 19 percent have no insurance, and 31 percent have Medicaid. Levit noted that if the residency program moves to St. Francis, a large portion of it will end up at the St. Francis Hospital near 91st Street and S. Garnett Road, a much less convenient location for many of those uninsured and underinsured residents.

"Unfortunately a solution which moves OSU to far south Tulsa and out from its current location might help stabilize the academic program, but it would be terribly destabilizing to an already seriously challenged indigent care fabric that's already in tatters," he said. "We need a better solution than that."