After threatening to close several times, the doors finally shut at a 60-year-old hospital that serves mostly low-income patients on Tuesday, with saddened doctors and nurses gathering around a flag-pole to say goodbye to Doctors Medical Center San Pablo.
With "Amazing Grace" playing in the background, about 50 staff members hugged, cried and worried about what's next for them and their patients.
"It's really hard, it's really emotional," said Latona Whitaker, a longtime Emergency Room administrator and billing department employee.
She said she got calls early Tuesday morning from a patient who couldn't breathe, asking "Where do I go?" Others called with medical emergencies, she said, "and they're in a panic."
She herself doesn't know what to do. The hospital is blocks from her house. It's where she took her son when he collapsed on the basketball court with a heart condition, where Grandma came after a stroke. "I don't know what I'm going to do," she said.
Patients needing emergency care will be taken to the closest hospital and those needing specialty care will be taken to the closest appropriate facility, the Contra Costa Health Services advises on its website. Still, as Whitaker pointed out, many patients are not wealthy and don't own cars. "They come here in taxi cabs," she said, saying that farther trips will cost more money. "Lots of people will lose their lives," she said. "They'll stay home and not get treated."
The closure has been expected for a while while the West Contra Costa Healthcare District Board struggled to close an $18 million annual operating deficit. In June, the board voting that closing down on Tuesday was the only option.
Still, the decision was made "reluctantly," according to a March news release that warned of the closure.
“This is a very sad day and a huge loss for our community and for all of us who have worked so hard to keep our community hospital open for all our residents in time of need,” Eric Zell, chairman of the District’s elected board of directors, said at the time. “We have exhaustively pursued every alternative over the past weeks, months and years. Unfortunately, we have completely run out of viable and responsible options.”
The hospital has been the only public medical center serving 250,000 residents between Berkeley and Vallejo.
Much of its financial problems arose because more than 80 percent of its patients were covered by Medicare or the state-federal Medicaid program known as Medi-Cal. Fewer than 10 percent of the hospital’s patients had private insurance. As the East Bay Express noted in a series of articles, many public hospitals such as Doctors Medical Center, have shouldered the burden of caring for the poor, while private hospitals fail to do so despite being given huge tax breaks.
It's a problem plaguing the rest of the country too. In Cleveland, the Maynard Media Center of Structural Inequity noted how the Cleveland Clinic wants to close a local trauma center in a poor, minority neighborhood.
Tenet Healthcare, a for-profit health organization that specializes in turning around struggling hospitals, took over Doctors in 1997 but did not renew its lease in 2004, returning the hospital to the management of the West Contra Costa Healthcare District.
There have been other financial down periods as well, including when the hospital suffered $23 million in operating losses in 2005 and another $35 million in operating losses the following year prompting the district to file for Chapter 9 bankruptcy.
Still, the medical center was able to survive after a series of closure-threatenings and last-minute saves.
For example, residents approved two parcel tax measures in 2004 and 2011 raising a total of $10.7 million. And in 2008, Kaiser, Alta Bates Summit Medical Center and Walnut Creek’s John Muir Health System gave a combined $17 million through 2010 to keep Doctors open.
But residents in May voted by 52 percent to approve a third parcel tax measure, but it ended up failing because it needed a super majority. And funding appeals to corporations such as Chevron, Republic Services and Mechanics Banks, and foundations including the Gate Foundation Health Initiative were unsuccessful.