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Lake Placid’s ER situation is a harsh reality

May 23, 2013
Lake Placid News

The situation with the emergency room in Lake Placid is unfortunate, but if - or most likely when - the conversion is made to an urgent care unit, it will not be the end of the world.

Certainly residents of this village and town are upset at this possibility. Change usually brings with it unwanted anxiety and stress, but unfortunately, cutbacks in services and funding are a harsh reality of today's world.

It is understandable that many people are upset about the recommendation by doctors and administrators that Adirondack Health convert the 24-hour emergency room at its Lake Placid hospital to a 12-hour urgent care clinic. The doctors and administrators have to cut services somewhere, given that Adirondack Health lost $3 million last year and, so far this year, has taken a combined hit of $1.7 million in Medicare payments from the fiscal cliff and the sequester.

The plan is not to close Lake Placid's Adirondack Medical Center entirely, as some people may think. Sports medicine and doctors' offices would remain, along with the proposed urgent-care clinic, although they'd all eventually be moved across Old Military Road to a new building on the Uihlein campus. The old Placid Memorial Hospital building has served the community well for quite some time, but Adirondack Health's plan to build a new, more efficient facility deserves some applause.

It's been more than six years since Adirondack Health took over the Lake Placid (Uihlein) and Tupper Lake (Mercy) nursing homes from the Sisters of Mercy, who could no longer take the financial bleeding. Unfortunately, Adirondack Health inherited those deficits, which have cost it millions of dollars. Each nursing home resident costs Adirondack Health about $200 a day, but Medicaid pays much less than that. It seems there's no way anymore to sustain a nursing home - in New York state, at least. Even Essex and Franklin counties are divesting themselves of their homes in Elizabethtown and Malone.

Adirondack Health is a private entity, and can't stay on this path. The emergency department at AMC-Lake Placid is an example of costly community service, and its CEO Chandler Ralph said it ran a half-million dollars in the red last year. The Lake Placid emergency department has a small and dropping number of patients. Dr. Anthony Dowidowicz, medical director of the AMC emergency departments, and Chief Medical Officer Dr. John Broderick have been saying for years that it's unnecessary, medically, to maintain two emergency departments 11 miles apart. Now that something must be cut, they say this would be a good place to start. It might be hard to admit, but that makes sense.

Many people in Lake Placid are against the move to turn Adirondack Health's 24-hour emergency room at its Lake Placid hospital to a 12-hour urgent care clinic. The village board seems to be preparing to formally oppose it and the local arguments for keeping the Lake Placid ER have been passionate, but if one wants to seriously prepare for the future, it's better to be logical. And logic dictates that converting the Lake Placid emergency department is a fairly small sacrifice, one worth making to help Adirondack Health stay solvent as a whole.

Some residents have written that they, or people they love, would have died if they had to go an extra 11 miles, but already ambulances take all patients in critical situations to AMC-Saranac Lake, where there is advanced medical imaging and an operating room. But the fact is that there are other areas in the Adirondacks that require a longer distance of travel to reach an emergency room, such as Tupper Lake, which is twice as far from Adirdondack Health in Saranac Lake than Lake Placid.

There has also been some cause for alarm that those taking part in major sporting events in the area won't get the critical they need on case of an accident. But during these events the Lake Placid hospital could and probably would increase its services as needed.

No one is happy about a reduced hospital service, but it might not be as severe as some people believe. AMC-Lake Placid's emergency department doesn't go much beyond the minimum threshold now. Bringing it just below the emergency department threshold would save Adirondack Health a lot of money and lose relatively little: overnight hours, one nurse per shift and some lab capability.

Looking at the numbers, Lake Placid's residents and tourists don't use the emergency department enough, and it doesn't make financial sense for Adirondack Health to keep it here.

This area is blessed to have Adirondack Health. Few communities the size of ours have such excellent medical facilities. Change is difficult, but as difficult as the conversion of the Lake Placid ER may be to accept, it is something that must be done to keep Adirondack Health in the region, otherwise one day, someone who needs emergency medical attention may just have to go to a hospital in Plattsburgh.



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