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SF General Call for More Funding

Photo courtesy SFGH

By Ethen Lieser

When there isn’t enough money to go around, somebody suffers. Such was the case for San Francisco General Hospital (SFGH), which provides contractual medical services and manages the relationship between UCSF School of Medicine and the Department of Public Health/Community Health Network. SFGH believes the 2000-2001 budget allotted by Mayor Willie Brown is at least $5.1 million less than anticipated, which could hinder its current level of services.

“This just leads to gradual erosion in the services we can provide,” Helen Chen, the medical director at SFGH since 1996, said. “It’s a struggle to give the people the care they deserve. We’re talking about basic human rights, basic health care. It’s not about getting more money so we can do more, but rather getting more money to continue to do what we have been doing.”

Specifically, the $5.1 million dollar shortfall will prohibit the hospital from making “cost of living adjustments and other inflationary increases,” said Philip Hopewell, the associate dean at SFGA. According to Hopewell, given the cost of living in San Francisco and the Bay Area, SFGH physicians’ salaries are in the lower one-third of the national average.

Without the funds, SFGH is short-handed in recruiting and retaining needed anesthesiologists and other professionals. SFGH’s current anesthesiologists work 70-to-80 hour weeks. They agreed to this schedule only until July 1. For Chen, who works in the primary care sector, losing part of her staff seems likely.

“It’s very hard to attract new people and to keep the people you already have,” Chen said. “If we don’t get the level of funding needed, we could lose parts of positions and lose the amount of access patients have to our clinics.”

Said Hopewell: “There probably won’t be a dramatic exodus of physicians … but a gradual attrition of physicians because we are not able to replace them.”

Some of the services that could be cut include emergency service, radiology and neurosurgery — all part of the trauma program. In the works are new trauma initiatives in next year’s budget, but reductions in funding will likely inhibit the program’s growth — and SFGH in general. “The hospital here is very intertwined and interdependent. So there could be a domino effect if you cut anything,” Hopewell said.

SFGH has also requested funding for an additional neurosurgeon. Only 1.5 neurosurgeons provide round-the-clock coverage, and at least two operating rooms during weekdays may be forced to close if additional funds are not provided.

“You would probably see increased wait-times in clinics, emergency departments, radiology and other diagnostic services,” Hopewell said.

Furthermore, the savings from budget cuts could trigger a substantial loss in revenues. SFGH estimated that the proposed $168,000 reduction to the Positive Health Program’s clinic services will equal $220,000 of lost revenue.

“This situation is a little discouraging because of our commitment to working for General Hospital and the patients,” Chen said. “And we have always been paid less here, but that has never been an issue because we didn’t get into this for the money. But to care for the patients, the contract said that we need to provide quality care for the patients. And we can’t do that if we don’t have access to the basic stuff.

“I’m going to be optimistic and hopeful. I’m hoping the mayor and the supervisors will see fit to allocate the funds to keep us where we’re at.”