2 Hospitals Enter Clinics’ Field--On-the-Job Injuries

An increasingly competitive atmosphere has prompted two San Gabriel Valley hospitals to turn to a field previously dominated by industrial medical clinics.

In a long-range effort to attract patients, San Gabriel Valley Medical Center in San Gabriel and Methodist Hospital of Southern California in Arcadia have set up programs for employers who must provide medical care for employees injured on the job.

Under the state workers compensation law, an employee who reports even the most minor injury at the workplace--such as a cut finger or a pulled muscle--must receive medical attention. Workers compensation insurance, required of all employers, covers the entire cost.

Direct Competition

The new programs, operated out of emergency rooms, put the two hospitals in direct competition with at least 10 industrial medical clinics that have handled minor emergencies for many San Gabriel Valley businesses over the past 10 years.

“We will be as competitive (with) clinics in cost as possible,” said Dr. Richard Bukata, emergency medical director of San Gabriel Valley Medical Center.

“The fee schedule paid by workers compensation is reasonable and clinics are paid the same as us, so we are not undercutting each others’ fees,” Bukata said. “We don’t lose money on a workers comp situation because we are assured of payment at a reasonable fee.”

Bukata said his medical center has been searching for ways to attract new patients since 1983. At that time, restrictions imposed on Medicare patients contributed to an increase in the number of empty hospital beds.

Expanded Services

“As hospitals look for new markets, occupational medicine is one of the good ones,” Bukata said.

“Hospitals want as many patients as possible, so they have expanded their activities to more outpatient programs, such as stop-smoking and weight control,” Bukata said. “If a patient comes here and has a good experience, he will come here again.”

The two hospital occupational programs are similar to those offered by clinics.

San Gabriel, which routinely handled about 100 job-related injuries a month in its emergency room before it began its FirstMed program, now also offers such services as pre-employment and annual physical examinations, quick registration, follow-up care, rides back to work, work site safety evaluations and simplified billing procedures.

Liaison Service

A liaison nurse also works closely with employers, keeping them informed of an injured employee’s progress and condition and acting as the employer’s link to the hospital.

Methodist, which handles 120 to 150 on-the-job injuries a month, plans to implement its expanded program in the near future, offering similar services.

Although neither hospital will require businesses to sign contracts, the new services are intended to assure them that an injured employee will be treated promptly without going through the usual hospital red tape, which causes delays that have discouraged some employers from using hospitals to treat routine on-the-job injuries.

San Gabriel City Manager Bob Clute said his city normally sends its 150 employees to Flair Park Medical Center in San Gabriel when they are injured at work.

No Medical Difference

“I would consider the hospital, but (medically) they are no different than anyone else,” Clute said. “Clinics have been at it a long time, so they are good, and hospitals tend to be expensive and slow.”

Bukata said his medical center’s program can counter those concerns, both by eliminating red tape and charging no more than the rate set by workers compensation insurance.

Both hospital and clinic officials agree that because there are logistic limits--about 15 minutes’ travel time--as to how far an employer can transport an injured employee, the field should be large enough for both types of facilities.

However, Dr. Henri Cuddihy, administrator and part owner of Foothill Industrial Medical Clinic, which operates clinics in Duarte and El Monte, said, “It could overload the market if hospitals do a good job. But hospitals are large and react more slowly to market forces. And this is a new field for hospitals.”

Switch by Pasadena

The Foothill clinics, established in 1978, serve the cities of Duarte, Monrovia and El Monte and served Pasadena until two years ago when Huntington Memorial Hospital opened its Center for Occupational Health near its emergency room.

“We switched to the Huntington because it is closer and has an emergency room on the premises,” said June Callahan, workers compensation coordinator for the city.

The city’s 1,700 employees suffer about 430 industrial injuries a year.

The center at the Huntington, which shares staff with the emergency room, was started because the hospital was approached by city officials and business owners, said director Betty Briggs. Each month it treats between 700 and 800 workers from about 45 local employers.

Different Approaches

For the past three years Inter-Community Medical Center in Covina has offered an occupational health service program through its emergency room. The program is designed to treat people injured on the job in less than one hour and to reduce paper work.

While programs at San Gabriel and Methodist are operated out of their emergency rooms and Huntington’s out of a building next door, Queen of the Valley Hospital in West Covina bought and now runs an industrial medical clinic, Tri-City Industrial Inc., in the City of Industry.

And Central Avenue Urgent Care Center in Montclair refers patients to nearby Pomona Valley Community Hospital.

Foothill Presbyterian Hospital in Glendora is analyzing the market to see if there is a need for such a service. “We would have to hire a full-time liaison person if we adopted a program,” said vice president Ned Miller.

San Gabriel’s Bukata said one advantage of handling industrial accidents through an emergency room is that people whose injuries are worse than originally thought do not have to be transferred to another facility.

“But the major potential drawback is a disaster, like a bus accident on the freeway, which would tie up the emergency room so we couldn’t expedite the injured workers.”