BACKPAGE EDITORIAL

All ERs are NOT Created Equal

OPMC should not be a trauma center

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It’s been a while since I’ve written here. I usually do so only when I’m irritated, and as luck would have it, I’m irritated. Many things make me to want to write here. For example, the never-ending homicide circus that is Duuuuvaallll. I’ve lived here for nearly 20 years and the one thing that’s remained constant is the violence. Nothing changes it. Not weather, not money, not jobs, not football, not more cops, not new mayors, not city council—nada. It’s a constant. But that’s not why I’m writing in this space today. I’m writing because I am completely baffled as to why Orange Park Medical Center—a place which sees much of this daily bloodshed—has become a ‘go to’ trauma center here where Florida begins. There was a time not long ago when it was considered by many professionals in the local healthcare industry to be a “dump,” but these days it seems to be the ER du jour when it comes to anything trauma. Why?

Before you blow me off, let me first tell you that I used to work in the local EMS system. It changed my life. In fact, I’ve written about it here before and published a couple of books filled with my experiences. I’ve scraped my share of people matter off I-95 and spent more than enough time in the local emergency rooms. It’s my opinion that Orange Park Medical Center is, indeed, a dump. Don’t believe me? Go read some of their reviews online.

Has OPMC stepped up its game or are local and state politics dictating patient care now? Let’s find out.

The patient care at OPMC used to be an inside joke among medics. I’m not laughing anymore because every time I read the local news, I see critically injured people being dumped off there and cannot figure out why.

Recently, two roofers in Mandarin were struck by lightning, fell, and then were taken to OPMC. They were described as “critical” so I have to ask: Why would Rescue take them there?

I have no recourse for this. There’s no one to ask. I can’t call Ken Amaro and say, “Hey, Ken, why is JFRD taking trauma victims to OPMC when everyone knows it’s a terrible hospital?”

You may or may not know this, but OPMC is not a Level I Trauma Center. It says so right on its website, and I quote, “As the only Level II Trauma Center in Clay County, Orange Park Medical Center has the proven expertise to save lives within the golden hour.”

Yeah … no. I could tell you stories about that place. I have seen shit. And yes, Clay County is out there, but trust me when I tell you, any EMT worth their patch can make it Downtown in time. I did. So, the “golden hour” excuse is lame considering medics made it Downtown just fine before all of this.

You may not know this either, but all emergency rooms are not created equal and their designated trauma level matters!

What’s a Level I Trauma Center? It’s UF Health. UF Health is the state’s only designated Level I Trauma Center for the entire Northeast Florida region. It’s where you’re supposed to go for any and all serious injuries and medical emergencies. All medics know this, which begs the question, why are they taking people to OPMC?

Typically, a Level I ER is required to have surgeons physically present at the hospital, 24/7. Level II’s are not so required. Level I trauma centers are teaching hospitals with access to everything, research, education and burn centers. Level IIs? Nope.

To put it bluntly, despite being in the middle of a war zone, UF Health is as good as it gets as far as ERs go here; it’s well-equipped and Life Flight is based there. OPMC? The care there is nowhere near as good as at UF Health.

All of this has been argued in court the past few years and, according to the Department of Health’s website, OPMC is officially a “provisional level II trauma center,” the same as Memorial Hospital in Jax.

If OPMC is not a Level I trauma center, why does local EMS continue to take Level I patients there?

Ask Governor Rick Scott.

In January, administrative law judge W. David Watkins ruled that OPMC should never have been allowed to open its trauma center in 2016.

In fact, Gov. Scott, who has sought to eliminate the cap on the number of trauma centers in the state, argued that allowing more hospitals to operate as trauma centers will “save lives.” He clearly has never been to OPMC.

In his ruling, Watkins wrote:

During the first three months after Orange Park opened its trauma center in 2016, UF Health Jacksonville’s volume of its most severely injured patients decreased by 17 percent. Overall, UF Health projects an annual loss of 320 to 540 trauma cases caused by Orange Park’s operation of a trauma center.

Let that sink in and then consider how many patients are now transported to OPMC. As a “recommended order,” the ruling has no teeth.

So what the hell is going on? Are people being denied proper care because the governor wants some of these outlying hospitals to rake in a few extra bucks? Does he own stock in OPMC? I kid, I kid, but seriously, what gives? I cannot see a rational explanation for making OPMC a trauma center, when clearly the care there cannot compare to that of UF Health.

The hardworking people who operate the ambulances here are not dumb, nor lazy; quite the contrary. Typically, they want the best care for the patients they treat. That said, they do take orders and someone, somewhere is telling rescue to take people to OPMC in cases where they should clearly be going Downtown.

This is a big deal, and people should be raising hell over it, especially considering how many trauma cases occur here on a daily basis. Jax has yet to be dethroned as the murder capital of Florida, and if they suddenly renamed I-95 to ‘Death Race 2000,’ I doubt many would object.

In the meantime, while the lawyers sort this out over the next 20 years, if you happen to find yourself in the back of a rescue unit, and you’re fortunate enough to be conscious, you might want to tell your medic to take you anywhere but Clay County. Better yet, tattoo it on your chest. That’s just my personal bias, but I speak from experience. You do have a choice, after all.
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Rivera is a publisher and author in St. Augustine. Connect with him on Twitter @brokenswordpub.

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