CHOC Will Lay Off 12 Doctors, Fill Spots With Residents

Twelve physicians at Children’s Hospital of Orange County and its clinics are being laid off, but officials say other changes there will maintain the quality of care.

Twelve additional medical residents will be added to the hospital staff, replacing some of the laid-off doctors.

The La Veta Pediatric Medical Group, on contract with the hospital to staff CHOC’s three community clinics in Orange, Santa Ana and Anaheim, recently gave notice to 12 of its 22 doctors that they will be out of a job in mid-March.

However, only three of those doctors are now working in the clinics. The other nine have been used as “house staff’ inside the hospital, a role traditionally played by medical residents, said Dr. Jo Ann Nishimoto, the group’s medical director.

The hospital will fill that gap by increasing the number of residents to 36. Residents are licensed doctors who are undergoing extra training in a specialty, which is the standard in teaching hospitals, said Lori Teslow, a consultant to CHOC and La Veta Pediatrics.

Neither CHOC nor the physicians group would divulge the amount of the contract or how much money the hospital will save by the changes.

Last year, CHOC’s losses totaled $13 million. The hospital, which cares for the county’s most critically ill children, has been hit hard by managed-care health plans that have reduced the number of admissions. The hospital eliminated the equivalent of 83 jobs last year and nearly 200 in 1995.

The hospital’s three clinics offer primary pediatric care, such as well-baby check-ups, immunizations and treatment of flu and ear infections. Patients with chronic diseases, such as diabetes or asthma, or with life-threatening illnesses are referred to specialists at the hospital.

Most of the patients seen at the clinics are low-income, with Medi-Cal or other forms of public health insurance, Nishimoto said. Some patients have private insurance and others have no insurance at all.

“We do not turn away anyone based on their ability to pay,” she said.

The Orange clinic, located next to the hospital, has 70,000 patient visits a year, while the Santa Ana and Anaheim clinics have about 20,000 combined, a hospital spokeswoman said.

In an effort to stem losses, CHOC reviewed its contract with La Veta Pediatrics. Consultant Teslow concluded that often too many doctors were working when patient volume was light.

By scheduling more doctors to work at peak times, and by scheduling more appointments at busy times and fewer at other hours, the smaller physician staff will be able to see patients more efficiently, Nishimoto said.

She stressed that the same level of care will be available.

Nishimoto said the clinics are poised to receive new patients after July 1, when legislation goes into effect offering low-cost insurance to children of low-income parents who do not qualify for Medi-Cal. If patient volume rises, the group will hire more doctors.

CHOC also is served by about 40 physicians in the Pediatric Subspecialty Faculty, who treat serious illnesses and offer research and medical education. Also, about 250 community physicians have hospital privileges at CHOC.

CHOC’s precarious finances should be a concern to all of Orange County, said Felix Schwarz, executive director of the Health Care Council of Orange County.

He called for more public funding for CHOC and UCI Medical Center in Orange, considered the county’s “safety net” hospitals for the poor.