TWO HOSPITALS, ONE CITY

STORY AND PHOTOS BY SUSAN BURGESS

Two buildings, one a hospital and the other a medical office building, sit side by side east of U.S. 1 in Port St. Lucie, quietly symbolizing the rivalry between HCA St. Lucie Medical Center and Martin Memorial Health Systems for the medical business of Port St. Lucie residents.

They’ve been together since Martin Memorial bought the practice in the medical building in 1994.

But even before that, medical services were available in St. Lucie County from both healthcare systems. The Port St. Lucie hospital opened in 1983 and Martin Memorial opened its MediCenter on Port St. Lucie Boulevard that same year. The MediCenter was moved to St. Lucie West in 1995.

Now they both want to serve patients from the western part of St. Lucie County — Martin by building a new hospital in Tradition and a new emergency center in St. Lucie West; and St. Lucie Medical by continuing to use its expanding hospital, emergency center and physician practice east of U.S. 1, along with its new walk-in clinic in St. Lucie West.

MARTIN’S APPLICATION

Until the state finishes hearing appeals from the Hospital Corp. of America’s objections to Martin Memorial’s plan to build a new hospital, no one will know which side will prevail. But with the growing western population and increasing traffic load on roads to the existing hospital in Port St. Lucie, many have opinions.

“Considering the size of the city at build-out, which should be around 450,000 sometime after 2030, we’ll need several hospitals out there,” said Port St. Lucie Mayor Pat Christensen. “Who owns them remains to be seen, but personally, I’d like to see our residents have a choice. We certainly need a hospital in the west. It makes all the sense in the world. And if HCA was in a central location, I don’t think we’d need it so soon.”

Tradition resident Jessica Soumoff also thinks the western area needs a hospital.

“It’s very important that we have a hospital here,” she said. “I don’t know that I prefer one over the other as long as it offers quality care. It takes about 25 minutes or so to get to St. Lucie Medical Center from here when there is a lot of traffic.”

Martin Memorial filed an application with the state for a new 80-bed, $117 million hospital in Tradition in April 2007, after five years of trying to win state approval for a new hospital in St. Lucie West.

“Competition is good and helps ensure that hospitals are responsive to the needs of the community, but there are also commonalities among the needs of hospitals,” said Rich Rasmussen, spokesman for the Florida Hospital Association. “Bringing the specialists into Florida is still a challenge here. And the biggest issues hospitals are struggling with is the growing number of uninsured patients and getting enough physicians to respond to on-call services.”

WESTERN GROWTH

The entire western part of Port St. Lucie is responsible for most of the city’s 37,000 population increase in the past two years, said Mark Robitaille, senior vice president and chief operating officer of Martin Memorial Health Systems.

“We certainly feel the population is substantial enough for a new hospital,” he said. “The state of Florida agrees with us, which is why in June 2007 it granted a certificate of need to build a hospital in Tradition. And residents of western St. Lucie County have seen a need as well — in 2006, more than 10,000 community members signed petitions pledging their support for a new hospital there.”

The application received preliminary state approval in June, but a month later, HCA St. Lucie Medical Center denounced the application, with CEO Gary Cantrell issuing a written statement saying that Martin’s decision to build in western Port St. Lucie would threaten his hospital’s financial foundation.

“The reason we’re [both HCA hospitals in St. Lucie County] able to employ more than 2,000 employees, provide the wide range of services, pay more than $2.2 million in taxes and donate hundreds of thousands of dollars to local schools and community groups is because of the financial foundation we have built,” Cantrell wrote.

“All of that would be at risk. I doubt if you can find many people who are willing to give up something they have worked 20 years to achieve without a fight,” he said.

Mark Robitaille said the 69-year-old Martin Memorial, a not-for-profit organization, puts its money back into the organization in the form of capital improvements, purchase of advanced technologies and additional services.

APPEAL PLANS

St. Lucie Medical Center plans to appeal the state’s preliminary approval at an administrative hearing in November.

“With the legal challenges from HCA and expected future challenges, it could be another eight years at least before we even begin construction on a hospital at Tradition,” Robitaille said. “In the interim, western St. Lucie County continues to grow, increasing an already substantial need for medical services.”

To fill the gap, Martin Memorial plans to build a $4.1 million emergency center with 12-15 beds and all the capabilities of an in-hospital emergency room inside their existing St. Lucie West medical center. Construction begins in October, with completion expected in 12 to 16 months.

Cantrell voiced concern about the distance between the emergency center in St. Lucie West and Martin Memorial’s hospital on East Ocean Boulevard in Stuart.

“If a patient needs the level of care only provided by a full-service hospital, the treatment of a seriously ill patient could be delayed while the patient is being transferred to an appropriate facility,” Cantrell said. “Critically ill patients who come to one of our EDs [emergency departments], on the other hand, can be seen right away and have immediate access to all the capabilities of a full-service hospital.”

Residents question the ability of an ambulance to get through heavy traffic from western Port St. Lucie to the St. Lucie Medical Center. “We definitely need something closer to us,” said Port St. Lucie resident Nancy Dowd.

In St. Lucie County, EMS transports to hospitals increased 25 percent from 2003-2006, Robitaille said, adding that “in 2006, western Port St. Lucie generated 35,797 visits to an emergency department and Martin Memorial saw 5,873 emergency department patients from the area, in spite of being 15 miles away.”

PLANNED GROWTH

HCA opened a walk-in clinic in St. Lucie West about a year ago in a new professional building.

HCA also purchased in February the Heart and Family Health Institute across the street from St. Lucie Medical Center.

“We have 23 family physicians and board certified specialists, and a staff of 144, so you don’t have to go to many different places to get services,” said institute spokeswoman Roberta London. “There are just no other practices in the county that are like ours. We have about 30,000 to 35,000 active patients in any given year.”

St. Lucie Medical Center and HCA’s Lawnwood Regional Medical Center in Fort Pierce plan to continue their growth based on community needs, Cantrell said, citing a $22.4 million expansion at St. Lucie Medical Center that will turn an entire floor on the north side of the hospital into an orthopedic unit with operating rooms and about 35 beds. Lawnwood expanded its emergency room in the summer of 2006.

“St Lucie Medical Center and Lawnwood Regional Medical Center & Heart Institute have been providing health-care services in St. Lucie County for many years,” Cantrell said. “During that time, we have grown along with the community and thoughtfully expanded our services to meet our area’s health-care needs. We must continue to ensure that the expansion of healthcare services in St. Lucie County is done in a thoughtful manner based on our area’s needs.”

Although there are no immediate plans to expand St. Lucie Medical’s emergency room, steps have been taken to reduce wait times, said hospital spokeswoman Synetta Armstrong.

“While [emergency departments] are first and foremost for patients who truly need care in an emergency setting, we have successfully reduced wait times in our EDs significantly while treating more patients than ever,” she said.

A policy change requires that patients who are over the age of 5 and under the age of 60 who are assessed at the emergency department by qualified personnel as not needing emergency care are given a packet of information listing other care providers who may be able to see them.

Martin Memorial has short wait times at its emergency room in Stuart, Robitaille said. “Eighty-six percent of patients are seen by a physician or appropriate medical professional within 30 minutes or less. Ninety-nine percent are seen by a physician or appropriate medical professional in 60 minutes or less. We see everyone who comes in the door.”

After the Tradition hospital is built, Martin Memorial administrators will decide whether to change the St. Lucie West emergency room into something that fits new needs, he said.

“Healthy competition ensures that hospitals are providing information on the levels of service that they offer,” said Rasmussen, spokesman for the Florida Hospital Association, “and it also helps ensure that they are cost competitive in the community as well. Competition is great because people want choices.”