Fred Mogul, Reporter, WNYC News
Fred Mogul has been covering healthcare and medicine for WNYC since 2002.
With four local hospitals closed because of Sandy, thousands of patients are scrambling to find other medical centers to treat everything from broken bones to brain cancer. The changes are causing inconvenience to some, but could be a mixed blessing for the hospitals on the receiving end.
When St. Luke's-Roosevelt Hospital opened a $21 million cardiac electrophysiology center in September, officials figured it would take months to build up enough patients to reach full capacity. The center’s state-of-the-art equipment helps doctors recalibrate faulty electrical impulses that cause arrhythmia. Before Sandy, there were only about a dozen patients a week, but now that displaced New York University doctors and patients are coming to St. Luke’s-Roosevelt, there are about 18 a week. Dr. Emad Aziz says that’s a big jump in a short amount of time, for a complicated and expensive procedure that can take up to eight hours.
“We really wanted to accommodate them,” he said. “And it turned out to be really nice, on a personal level, to assist them in a time when they have that big damage that I heard about.”
Bringing in the NYU doctors and patients so far has been good for cardiac electrophysiology at St. Lukes-Roosevelt, but it’s also provided challenges to both hospitals and patients.
Eileen Wal planned to fly from her home in Atlanta next month for reconstructive surgery at NYU, following a cancer-related mastectomy. Since Sandy, her surgeon, Dr. Robert Allen, has had nowhere else to operate locally. He also practices at Manhattan’s Eye and Ear Infirmary, but that, too, has been filled to capacity, thanks to the cascading effects of Sandy. Wal said there are no openings available in the operating room.
“Now some may pop up," Wal said, "but it would only be very last-minute, so the only people who could take advantage of it would be someone who’s local to New York.”
Fortunately for Wal, Dr. Allen spends half his time working and teaching at Ochsner Baptist Medical Center in New Orleans, so she can go there for the operation. But she’s not looking forward to spending time in The Big Easy.
“The surgery in New York was far easier for me logistically,” she said. “One, it has public transport, and, two, you walk out of your door, and you have all the food you could want. You don’t have to deal with anything. It’s all very simple. New Orleans, basically, there’s nothing there. It’s in the middle of nowhere.”
When it’s up and running, NYU performs about 27-hundred inpatient procedures a month. Officals haven’t said how long they expect Tisch Hospital, the core facility, will remain closed, but other medical centers are bracing for it to be months.
Lenox Hill Hospital, on the Upper East Side, was operating well under capacity before Sandy. It has about 600 beds, and daily occupancy was running “in the mid-400s,” according to Dr. Arthur Klein, regional executive director for Northshore-LIJ, Lenox Hill’s parent system. Since Sandy, there are about 100 additional inpatients a day. Lenox Hill, which has struggled financially, has fast-tracked admitting credentials to about 300 NYU doctors and is additionally employing close to 500 NYU nurses.
Nearby New York-Presbyterian Weill Cornell Medical Center is not so eager to take on more patients and isn’t credentialing NYU doctors. CEO Dr. Steven Corwin says his hospital can barely keep pace with the increased number of people coming into the emergency room. And he’s concerned about what might happen in the event of a big public health crisis.
“If we were to have a significant flu season over the winter time, that would further hamper our ability to respond,” Corwin said.
Of the four closed hospitals, only NYU lacks a network and sister institutions to place patients. Bellevue, the largest shuttered facility, and Coney Island are part of the city’s Health and Hospitals Corporation, with nine other hospitals. And the Manhattan Veterans Administration Hospital has transferred most of its inpatients to the Brooklyn V.A.
By all indications, the placement of NYU patients to other institutions has been piecemeal.
Mike McCarry, head of perioperative services for Mt. Sinai Medical Center, said that he would have expected the federal or city government to have intervened and helped to distribute patients in the closed hospitals to surrounding facilities.
“Maybe that’s happening, but if it is, it isn’t visible," he said.
Several of the medical centers taking in patients evacuated from other hospitals immediately before and after Sandy initially reported losing millions of dollars—with much of the shortfall the result of taking in Medicaid and uninsured patients from Bellevue and, in some cases, displaced nursing home residents.
But in the months ahead, those hospitals that take on NYU patients needing high-end inpatient procedures are likely to see a temporary surge in profits—and possibly win new long-term patients. And they will likely earn millions of dollars a month they would not get, if NYU were open.