Tampabay: All Children's to join pediatric care giant

[Times photo: Bill Serne]
Melissa Koon watches her 1-week-old son, Michael Thomas, as nurse Margie Baldwin checks his vital signs Friday at All Children's Hospital in St. Petersburg.

ST. PETERSBURG -- All Children's Hospital and BayCare Health System on Friday announced plans for a new partnership to provide pediatric care in a large area of west-central Florida.

It will be called All Children's Health System and will consist of All Children's Hospital and the pediatric components of hospitals in the BayCare alliance.

As part of the change, Tampa Children's Hospital, a 163-bed unit at St. Joseph's Hospital, will be renamed All Children's Hospital at St. Joseph's.

All Children's President Dennis Sexton, who also will be president of the new system, and BayCare President Frank Murphy said the arrangement promises better care for children, as well as cost savings.

"By pulling this all together in one system, we're going to be able to have a consolidation of the expertise to care for these kids, no matter where they are," Sexton said.

"The idea is to be able to provide the services that are most appropriate at the closest facility. You have more sites, outpatient and inpatient, to access the system."

Murphy said the alliance is expected to save about $10-million a year by sharing resources, staff and some administrative functions. No staff cuts are predicted.

"We know from the experience of BayCare, there are certain duplication of costs that can be eliminated," Murphy said. "I think the important point that you should hear is we don't see any kind of impact on direct patient care."

If the two can successfully coordinate their systems -- a daunting task, doctors say -- they will create a pediatric colossus. All Children's has nine satellite clinics in six counties, from Citrus south to Fort Myers and west to Lakeland. Tampa Children's has five, and Murphy and Sexton said the new system likely will add more.

BayCare hospitals -- St. Joseph's, St. Anthony's, South Florida Baptist, Morton Plant, Bayfront Medical Center and North Bay in Pasco County -- boast 12,000 doctors and see hundreds of thousands of patients. Even though Bayfront is leaving the alliance at year's end, the hospital will continue to refer pediatric cases to All Children's.

Sick children tend to have complex, expensive problems. Funneling those children into one system can reduce costs and provide the critical mass of patients that pediatric specialists desire, experts say.

"To be most efficient, you need a certain population of kids," said Dr. Al Saltiel, former chief of staff at All Children's and president of Pediatric Associates of Florida, which represents 200 doctors.

"Geographically, in this west coast of Florida, you don't achieve that unless you go out a few counties. It would make sense for one hospital system to manage those needs."

All Children's board of directors will be abolished, and the hospital and BayCare will appoint a new board to run All Children's Health System, although the breakdown has not been determined. Each party will retain control of its assets and foundations. But Sexton said All Children's Foundation likely will raise money for its partners, too.

Sexton and Isaac Mallah, CEO and president of St. Joseph's-South Florida Baptist Health Care, said they do not foresee stripping Tampa Children's. The hospital opened in March 1998 and offers a full range of pediatric care.

"There's a certain level of service that people in Hillsborough County will demand, regardless of what we do on this side," Sexton said.

But putting the All Children's name on Tampa Children's is ironic, because Sexton fought the state permit that Tampa Children's needed to open. When All Children's next-door neighbor, Bayfront, joined BayCare in 1997, Sexton fretted that children who normally would be transferred to his hospital instead would be shipped to Tampa Children's.

Friday, everyone brushed over past contretemps. "We kind of put aside all kinds of issues . . . and decided to do what's best for children," Sexton said.

Sexton and Murphy are both known as strong -- and sometimes headstrong -- leaders whose organizations have competed vigorously for patients. Dr. Jay Wolfson, a professor of public health and medicine and health law and finance at the University of South Florida, said cooperating will help both.

Since BayCare was formed, it says, its members have saved up to $90-million. All Children's, meanwhile, has a national reputation for research-driven care, Wolfson said.

Working with BayCare will give All Children's deeper pockets and an extended network of physicians from whom to draw patients, he said.

"This becomes less of a power issue and more of a success issue," Wolfson said. "It shows the pragmatic nature of the market, that both Murphy and Sexton are flexible enough, smart enough and good enough managers to make the right decision to benefit the community."

Friday afternoon, several doctors who practice at All Children's and Tampa Children's applauded the new alliance, at least as it was presented, but warned support will not be universal.

"Most of us are hopeful that this is a good thing," said Dr. Rick Martinez, a pediatric cardiologist and the chief of staff at All Children's Hospital.

"Are we worried that it could be a bad thing? I think we're always worried about something new. But as long as we're involved in quality issues and delivery of care issues, I think we'll be happy."

Leaders from St. Joseph's and All Children's promised that doctors and staff would help determine what services should be offered where.

But parents shouldn't look for big changes fast. The governing bodies of BayCare and All Children's simply have signed a letter of intent to cooperate, and will spend the next six months forming a business plan and examining each other's finances, management structures and other data.

One issue All Children's had to consider was the Catholic ethical and religious directives for health care. Because BayCare includes two Catholic hospitals, members and partners must abide by those directives, which ban abortion, forbid sterilization and set boundaries on research and end-of-life care.

Those directives ultimately forced Bayfront from the alliance. Although Bayfront is private, it sits on land owned by St. Petersburg, and the City Council sued on grounds that following Catholic doctrine violated the separation of church and state.

All Children's should face no such challenges, because it is totally private. But Sexton said he consulted with outside experts before deciding the directives would present no problem. All Children's will remain secular, he said.

Many of the practical effects of the directives are manifested in gynecological and obstetrical services, which All Children's does not provide.

"We made a huge effort to find out how these would affect us and really couldn't find anything," Sexton said.

Meanwhile, Sexton said the alliance should not affect All Children's relationship with Bayfront. The two hospitals share a pediatric trauma program and other services, and All Children's performs open heart surgeries for Bayfront adult patients.

Dr. Larry Davis, chairman of Bayfront's board of directors, said he is not concerned, either.

Martinez, who as chief of staff also serves on the All Children's board of directors, said the new partners will have to overcome the inevitable clash of cultures and be willing to make hard decisions.

"There's a certain amount of civic pride on both sides of the bay that need to be put aside to make this work," he said. "It will involve, I'm sure, some compromise on issues that are difficult issues."