Hospital Changes Name, Will Stress Care of Poor : Medicine: Physicians & Surgeons becomes San Diego General and plans new programs for care of low-income patients.

Acknowledging that for years the hospital has tried to be everything but what it is, administrators at San Diego Physicians & Surgeons Hospital have changed its name to San Diego General Hospital and embarked on ambitious plans aimed at the needs of low-income patients.

Adopted on July 1, the new name is designed to boldly embrace the longtime image of the 107-bed hospital at 446 26th St. in Southeast San Diego as a haven for the poor.

“The bottom line is that for years the hospital has struggled to be something it’s really not,” said Jim Zanca, corporate vice president for the hospital’s new owners. “There is a community, and there is a service to be met in this area. Let’s stop fooling around, and let’s provide that service. A Scripps or a Sharp, we’ll never be. We’re San Diego General, and we’re proud of it.”

Zanca and San Diego General’s administrator, Tom Hennessy, describe an ambitious program directly aimed at two of the biggest problems in health care in San Diego County:

* The lack of prenatal care for low-income women. Each year, nearly 3,000 such woman show up in emergency rooms to deliver babies that are more likely to be sick or premature because of their mothers’ lack of care.

* Poor people who use the emergency room as their only source of medical care.

Not only is San Diego General close to receiving final state approval for funds that would help improve its emergency room, but it also hopes to have a new obstetrics unit established by next June, state and hospital officials say.

In a county that has been bogged down for years on these issues, and at a university hospital that has been pushing other health care providers to share some of the burden of caring for poor people, the moves at San Diego General are being enthusiastically greeted.

UCSD Medical Center officials are meeting with San Diego General officials to try to set up the new obstetrics unit. Indeed, it was UCSD that broached the idea in the first place.

“I had spoken with them some time ago, in a completely independent way, when we were looking at how do we turn (Physicians and Surgeons) into a viable hospital,” said Jan Spencley, director of legislative and government programs at UCSD Medical Center.

“If you look at it in a very simplistic fashion, it’s a question of how do you become a community hospital. And, if you don’t provide services to women and children, it’s pretty hard to be a community hospital,” Spencley said.

Dr. Lisa Firth, director of the Regional Perinatal System, which monitors the prenatal-care problem, said San Diego General’s plans are surprising and welcome.

“Most definitely, it would let UCSD do what it does best--take care of high-risk moms and infants,” Firth said. “The demand (for low-income pregnancy care) is increasing all the time, so another facility out there would be great.”

Although discussions are preliminary, Zanca said, UCSD might agree to provide staffing for the new obstetrics unit and the prenatal clinic it would include. This would solve the potential problem of recruiting doctors willing to serve a primarily Medi-Cal clientele.

Medi-Cal is the state’s medical care program that pays for care for the indigent.

A local program administered by a national obstetricians’ group is trying to encourage private physicians to accept Medi-Cal patients, but the red tape and historically low reimbursement rates have made doctors reluctant to sign up.

So far, the effort has led 33 obstetricians in the county to begin taking Medi-Cal patients, said Linda Bethel, program coordinator. About 60 previously were taking Medi-Cal patients, she said.

The new San Diego General is the hospital that has resulted from the $6.5-million sale of Physicians & Surgeons by National Medical Enterprises, one of the biggest hospital companies in the country.

In the several years NME ran the hospital, it repeatedly threatened to close the emergency room because so many poor people were using it for primary medical care, which the state and county reimbursed either minimally or not at all. Losses totaled about $20 million over seven years, NME said.

The hospital was built in 1972 as San Diego Community Hospital, under an agreement in which the city of San Diego was trying to assure hospital access for Southeast San Diego residents. However, the hospital quickly suffered financial troubles and eventually was taken over by NME, which renamed it Physicians & Surgeons.

After restrictions in the hospital’s original construction agreement with the city were settled last year, an investors’ group bought the hospital.

Called Christian Hospital of San Diego Inc., the new ownership is made up of principals in a small health care firm, Nationwide Medical Systems, that operates a small hospital in Perris, Calif., plus $40,000 each from 35 local investor physicians.

Although changing Physicians & Surgeons’ name to Christian Hospital was considered, it was eventually decided that San Diego General fit better, Zanca said.

Telephone operators at the hospital have begun to use the new name, but the change has yet to be announced with a new sign outside.

Administrator Hennessy said the new obstetrics unit remains in the planning stages, but it probably will have 12 to 20 beds. As for the number of births there, “200 to 400 a month would make me happy, but I’m not sure,” Hennessy said.

There are more than 40,000 babies born annually in San Diego County.

He estimated that it will take about $750,000 to remodel and equip an obstetrics unit, a sum that he hopes will come from at least partly from cigarette tax funds that the state has made available to the county for capital spending on health care.

“We just got notified by the state that they were willing to help us, less than a month ago,” Hennessy said. “We’ve been assured that some of those funds have been set aside for us if we decide to go ahead with the project.”

The obstetrics unit will be built “if the state funding arrives as anticipated,” Hennessy said.

The county has been awarded $4.4 million in such capital funds to spend over the next five years, said Dr. Peter Abbott, chief of the county health services branch at the state Department of Health Services. Although the county recommends which projects the money should fund, the state has to approve, Abbott said.

Abbott said a $220,000 state contribution toward remodeling San Diego General’s emergency room is farthest along toward approval. He said he is not sure about the other grant to which Hennessy referred.

Paul Simms, director of physical health services for San Diego County, could not be reach for comment on what role, if any, the county is playing in the plans for turning San Diego General into a community hospital.