Kids in South Florida are being taken throughout county traces or flown to different states for specialised medical care they’ll’t get near residence.
A plan to consolidate medical pediatric therapy in South Florida, although, may end result within the creation of an enormous kids’s hospital system offering specialised care at present out there solely in different states. Nonetheless, the thought has prompted some friction amongst medical doctors.
Leaders at Nicklaus Kids’s Well being System, Joe DiMaggo Kids’s Hospital, and Broward Well being say they need to develop a big well being system much like Kids’s Healthcare of Atlanta that gives medical care to infants, kids, teenagers, and younger adults.
“I need kids locally to have the very best specialty care accessible to them wherever they’re,” stated Caitlin Beck Stella, CEO of Joe DiMaggio Kids’s Hospital in Hollywood. “We have a look at the long run and we’re speaking a few greater image for kids’s well being, so a Kids’s Hospital of Florida, idea. That’s the proper mannequin. That’s the mannequin that’s been established across the nation.”
The altering dynamics
Step one towards this mannequin is underway: Nicklaus Kids’s Hospital in Miami is crossing the county line in a major strategy to associate with Broward Well being, the general public well being system in northern Broward County. As a part of a not too long ago authorized affiliation settlement, Nicklaus Kids’s Well being System is ready to turn into the pediatric supplier of Broward Well being’s Salah Basis Kids’s Hospital. Salah occupies two flooring in the Broward Well being Medical Middle in Fort Lauderdale and likewise gives companies via Broward Well being Coral Springs.
Miami’s Nicklaus has had a small presence in Broward for 27 years. Nonetheless, by the top of the 12 months, Nicklaus medical doctors will deal with all kids at Broward Well being’s flagship Fort Lauderdale hospital, observe up in close by medical workplaces, and deal with newborns within the neonatal intensive care unit.
Joe DiMaggio in South Broward and Salah in North Broward are a part of taxpayer-funded well being methods and should deal with all sufferers no matter their skill to pay. Nicklaus, a nonprofit in Miami, is South Florida’s solely standalone kids’s hospital and is funded primarily via donations.
Nicklaus Kids’s Well being president and CEO Matthew Love stated his pediatric employees at Broward Well being will work and reside in Broward County, quite than journey from Miami. Its medical doctors will add manpower so households don’t must drive to Miami, or endure lengthy wait instances to see a pediatric neurologist or ear, nostril and throat specialist as many now do, he stated. “We’re already establishing a really giant further outpatient location in Northern Broward,” Love stated.
“That is about how we assist northern Broward have nice pediatric companies,” he stated. “Joe DiMaggio is an effective group, however the breadth, depth, and scope of companies at Nicklaus are bigger. We’re 4 instances the scale of Joe DiMaggio by most metrics.”
Love, like Stella, sees a future the place South Florida’s kids’s hospitals be a part of to take care of pediatric sufferers. Collectively, they might entice coveted pediatric specialists to the area, practice new medical doctors, reduce on wait instances for pediatric appointments, and supply advanced medical care to the greater than 750,000 kids who reside within the tri-county space.
“I do have a imaginative and prescient of a pediatric healthcare supply system that rivals others throughout the nation,” Love stated. “We in Florida deserve it. Our children deserve it. We don’t need individuals leaving Broward or Palm Seashore or Miami-Dade and having to go to the northeast to get their pediatric well being care.
“Our purpose is to develop throughout South Florida, to create Kids’s Hospital of Florida, no matter you need to name it … in order that no child has to depart Florida,” he stated.
The instance native hospital leaders level out is Kids’s Healthcare of Atlanta, a consortium of three kids’s hospitals. CHOA is taken into account the most important healthcare supplier for kids in Georgia, providing greater than 60 pediatric specialties and offering kids entry to 2,300 physicians.
Some Joe DiMaggio medical doctors really feel slighted
Whereas native CEOs might have that imaginative and prescient, some Joe DiMaggio employees view the state of affairs in another way.
Memorial Healthcare, the mother or father of Joe DiMaggio, is at present collaborating with Broward Well being underneath a single interim CEO, Shane Strum; some employees at Memorial who’re chafing underneath Strum’s management are questioning why he would associate with a competing kids’s hospital. “There’s a core, vocal group who’re sad with the state of affairs,” stated a Joe DiMaggio physician who requested to not be named.
For many years, Joe DiMaggio Kids’s Hospital has been the premier vacation spot for pediatric care in Broward County, treating kids for a variety of circumstances, from gunshot wounds and organ transplants to damaged bones or extreme infections. Situated subsequent to Memorial Regional in Hollywood, Joe DiMaggio has constructed its popularity and pediatric specialties over three a long time. Within the final two years, Joe DiMaggio expanded from 4 flooring to eight, including new know-how and pediatric ICU rooms. It additionally not too long ago added a pediatric cardiology group.
Strum, CEO of Broward Well being since 2021, grew to become the interim CEO of Memorial Healthcare System in September 2024. In his brief tenure, Strum has restructured departments at Memorial, fired employees and demoted division leaders. A half-dozen Joe DiMaggio workers instructed the South Florida Solar Sentinel they’re offended that the one two choices for physicians to work at a kids’s hospital in Broward now fall underneath the identical CEO. They requested to not be named and stated they concern for the way forward for Joe DiMaggio Kids’s Hospital.
“It’s only a matter of time earlier than Nicklaus assumes management of Joe DiMaggio,” somebody who recognized themself as a Memorial physician wrote in an e-mail to the South Florida Solar Sentinel. “It was all the time a part of the plan to associate with our solely actual competitor within the pediatric acute care house in South Florida … The Kids’s Hospital of Florida will eradicate competitors within the tri-county and immediately influence doctor compensation, as a result of there’s nowhere else to go with out leaving the market.”
Dr. Frank Scholl, a pediatric heart specialist at Joe DiMaggio, stated these voices symbolize a minority. Most medical doctors at Joe DiMaggio need to collaborate with their colleagues at different kids’s hospitals, together with these at Nicklaus, after they start working at Broward Well being. “We need to higher serve the affected person inhabitants all of us take care of,” he stated.
Scholl envisions Holtz Kids’s Hospital in Miami additionally taking part within the Kids’s Hospital of Florida. “By pooling our sources collectively, we will higher entice and retain expertise from a nationwide and inside pool that’s restricted,” he stated. “That’s an enormous issue on this. There are individuals in any respect three hospitals who actually need to collaborate.”
In the event that they had been to kind a united community and one native kids’s hospital had been to lure a high pediatric neurologist, a extremely sought-after specialty, all those that are a part of the Kids’s Hospital of Florida may faucet into that experience for consultations or referrals.
Missed alternative?
Whereas the larger imaginative and prescient for a future Kids’s Hospital of Florida contains Joe DiMaggio, for now, the Hollywood hospital will not be a part of the Broward Well being/Nicklaus partnership. Nonetheless, each Love at Nicklaus and Strum at Broward Well being say they independently had approached Memorial Healthcare System’s former CEO Scott Wester to collaborate or associate with Joe DiMaggio. Wester served as CEO from 2022 to 2024, serving solely two years on a three-year contract. He resigned underneath stress from the board in September 2024.
“Nothing got here out of that dialogue, and that was not my resolution,” Love stated. “I’d have beloved to have the ability to collaborate (with Joe DiMaggio). Shane had approached them first they usually had a possibility to do one thing huge and nice with Broward Well being and it was turned down.”
Wester didn’t return calls or textual content messages in search of remark.
“It feels like persons are mad as a result of we’re making an attempt to get good well being care to all the youngsters in Broward County,” stated Memorial Board member Doug Harrison. “On the subject of this concept of a Kids’s Hospital of Florida … my take is I simply need to present nice well being care for kids. It’s not a mysterious factor. There’s no inventory in it. There’s no cash in it. I’m not a health care provider. I don’t make any cash off of it. It’s concerning the kids of Broward County.”
Stella stated medical doctors at Joe DiMaggio who resent that Nicklaus has teamed up with Broward Well being are misguided and don’t perceive the “headwinds” dealing with kids’s hospitals: Extra kids on Medicaid quite than on higher-paying non-public medical health insurance, sicker kids with power circumstances or preventable illnesses, a better want for specialty care for kids with extra advanced diseases, fewer medical graduates pursuing pediatrics, and extra monetary stress.
Federal cuts to Medicaid, if handed on to states, may pose an issue, too, by jeopardizing the protection that pays for a lot of the pediatric hospital care in Florida. At Nicklaus, for instance, about 70% of sufferers use Medicaid.
The most effective path ahead for kids, Stella stated, is for Nicklaus, Joe DiMaggio and Broward Well being to work collectively, “and possibly even embody different kids’s hospitals in Miami or Palm Seashore.”
“When you pool your sources and also you regionalize applications and also you create facilities of excellence and also you come collectively underneath a bigger community or built-in supply system, you’re mainly directing kids to the place the place they may get the best degree, most specialised, most acceptable care,” she stated. “That’s the mannequin that’s taking place across the nation.”
Stella acknowledges a few of her medical employees aren’t comfortable about Nicklaus partnering with Broward Well being, or the idea of a Kids’s Hospital of Florida.
“It’s disruptive. We get it,” she stated. “We get that it’s an odd mind-set for people right here which are used to a really conventional healthcare mannequin. The market’s modified, although, and we now have to be considerate about what it’s going to appear to be 20 years from now, not 20 years behind us.”
In California, Kids’s Hospital of Orange County and Rady Kids’s Hospital San Diego introduced in January {that a} merger had been accomplished between their mother or father corporations, creating a brand new mixed healthcare system known as Rady Kids’s Well being. Every saved its separate medical employees, governing boards and onsite management.
Hospital executives stated the merger goals to create “one of many nation’s most superior pediatric healthcare methods.” The organizations say they’ll be capable to enhance affected person outcomes, broaden their analysis capabilities, and be higher positioned to draw and maintain high expertise.
“The regionalization of youngsters’s hospitals is an unimaginable mannequin,” stated Dana Ferrell Birchfield, government director of the Florida Affiliation of Kids’s Hospitals. “I’d like to see what they’ve been capable of do in Georgia occur in Florida. You don’t must have each service at each kids’s hospital as a result of they’ll collaborate and kind one supplier community.”
Hospitals nationwide that serve the overall inhabitants, from regional medical facilities to smaller native amenities, are closing down pediatric items. The motivation is monetary; hospitals earn more money from grownup sufferers.
Mother and father with extraordinarily sick kids who want specialised companies comparable to transplants and childhood most cancers or uncommon illness therapies usually flip to kids’s hospitals as a result of this care will not be offered at normal hospitals. They have an inclination to make use of Medicaid protection to entry extremely specialised companies, and Medicaid reimbursement is commonly far beneath the precise value of care.
Florida has 14 kids’s hospitals, 5 within the tri-county space of South Florida: Nicklaus Kids’s Hospital, Salah Basis Kids’s Hospital, Joe DiMaggio Kids’s Hospital, Holtz Kids’s Hospital at Miami Jackson Memorial Medical Middle, and Palm Seashore Kids’s Hospital at St. Mary’s Medical Middle.
Some households have reported touring outdoors the state after problem discovering specialists or getting well timed entry to wanted care for his or her kids, particularly for advanced or uncommon circumstances. Whereas nobody tracks what number of go away Florida, Strum at Broward Well being stated about 16% of pediatric sufferers go away Broward County for specialised care.
Strum stated the affiliation with Nicklaus will finally triple the scale of the pediatric employees at Broward Well being’s Salah Kids’s Hospital. However that’s simply the beginning, he stated, referencing his imaginative and prescient of a Kids’s Hospital of Florida: “Think about the mixed forces, the cross-pollination, the credentialing physicians may do to allow them to travel. It might truly change the pediatric panorama,” Strum stated, including that this imaginative and prescient might take time and child steps to perform.
Strum stated medical employees at Joe DiMaggio don’t have any motive to be fearful: “We need to develop. We need to get bigger. We need to recruit extra physicians. I imply, South Florida must be a hub for innovation and know-how within the healthcare house. The for-profits aren’t going to do the educational work … they aren’t going to coach future pediatricians since you don’t earn cash in that. However we will do it.”
Nicklaus has the most important doctor instructing program within the Southeast United States, and of its residents and fellows, about 70% keep in Florida, stated CEO Love. “By the Nicklaus affiliation, Salah shall be a sturdy pediatric hospital with each inpatient and outpatient, in addition to neighborhood exercise,” he stated.
Time will inform, says a skeptical Joe DiMaggio physician: “Quite a bit can occur with Nicklaus and Broward Well being … it could or might not work out. It could possibly be a failed partnership or it could possibly be an ideal one.”
If the partnership does work, the physician stated, then Memorial may discover a method for Joe DiMaggio to additionally associate with them. “That’s going to take buy-in, although. For a very long time, our medical doctors have checked out Nicklaus as competitors. It will likely be onerous to have a look at them as collaborators.”
Says Love: “This isn’t about Nicklaus Kids. It’s not about Joe DiMaggio. It’s not concerning the physicians. It’s not about Broward Well being. It’s actually across the children in our neighborhood. And if we all the time come again to that and go away our egos on the door, then we’ll get what we’d like achieved and the households of South Florida will profit.”
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