Mr. Yancy,

I don't know if this is under the council's purview, but I will ask. How in the world do we have three hospitals and not one of them provide pediatric services?

My son had to be transported to Texas Children's in The Woodlands yesterday afternoon and we are awaiting surgery this morning for appendicitis.

The added cost and time of not being able to do this at home in B/CS is something that I'm sure countless residents experience.

Again, I don't know if the council has control over this. If so, I think it is something worthwhile to explore.

Probably because people can travel 1-2 hours for dedicated children's hospital facilities. Kids aren't just small adults and their care requires special equipment & training. I know. Right there with you in the frustration of lack of pediatric specialists here. It's tough to attract even adult specialists (looking at you, neurologists) to live/work here, when plenty of people are willing to travel a few times a year to Houston/Austin for more timely appts. Ever tried to see a dermatologist here? Book now for Sept/Oct. I have a teen who needs scopes this summer- he's big enough to not *need* the specialized smaller equipment for kids - but we'll still have to go to Temple because his pediatric specialist has a hard time getting on the schedule here.

Eta: hope your kiddo has a smooth procedure!!

You must use Scott & White

Everyone in medicine - primary care, specialist, surgeons, anesthesiologist, nursing - have specialized into pediatrics. That's cool and great when you are TCH or Dell or McClain. But - it makes those without that specialized training unwilling and afraid to treat pediatric patients. Add the fact that inpatient admits for pediatric conditions are way down because pediatricians manage chronic conditions like asthma, diabetes, etc so well as outpatient care. Finally - there is the great gulf in pediatric reimbursement. On one end you have a ton of patients on Medicaid because of CHIPS. Which is a great thing but not how hospitals are going to fund their operations. On the other end you have TCH being where those with insurance want to take their high dollar procedures for their kids. TCH leverages that to the best rates for a hospital in the market from the private insurers - and therefore elbows anyone else from being able to pay their nurses or physicians what TCH can if the rest is apples to apples. It won't get solved here until we have a large enough population to support dedicated pediatric specialists living and practicing here full time. Haven't crossed that threshold yet. CommonSpirit can't afford to do it. BSW needs their CS operation to send kids to Temple to make Temple viable.

Why on earth would you want local government trying to get involved in healthcare?

There's an ER doctor at SJ in CS that shouldn't be treating people. If you've had her treat you, you already know. Not sure how she got through med school.

EFR said:

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Why on earth would you want local government trying to get involved in healthcare?

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this x 10000000

Howdy,

As the first chairman of the governance board of Baylor Scott & White College Station, from ribbon-cutting and through the merger with Baylor Health and other milestones, I am tremendously proud of my affiliation with this incredible community asset and the quality care that team provides. Next to the USAF, I've rarely been associated with such an effective team.

I'm no longer formally affiliated with them but I'll answer your question:

They DO provide pediatric care. There's approximately 20 pediatrics professionals located here in Brazos County. They are also a part of an Integrated Delivery Network, or IDN, which basically means if your child needs care protocols for which a children's hospital is more equipped to address, you'll get referred to a highly rated children's hospital in Temple.

The range of pediatric care here locally is fairly extensive, and I'm not sure why y'all were sent to Houston for appendicitis but I hope your kiddo is doing great now!

Our local hospital was built during a time when many were skeptical, and saying we couldn't sustain another one Brazos County. Could you imagine the issues we'd be having had we not built it? Since opening, there's been over $100,000,000 in additional investment and the Physicians Centre was recently added to the fold; numerous clinics and a pharmacy have been built and the ER and med/surg capacity has been expanded.

Our local system is consistently and repeatedly ranked among the highest in Texas on numerous fronts. And lastly, they are a fantastic employer that's growing fast, hiring more and constantly adding new specialties.

Sorry to get on my soapbox. I love that outfit. I could've answered "not my department anymore" but that's not in my DNA. ;-)

Respectfully

Yancy '95 Place 5

EBrazosAg said:

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EMTALA affects all er to er transfers which is what the OP described. One doesn't go from one hospital er to another's OR directly.

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Correct, we went from Premier ER in Bryan to TCH Woodlands.

And for the record, I love TCH and S&W in Temple. The same kid has been life-flighted to TCH in Houston and taken another ambulance to S&W in Temple. He has received great care. Still the added cost and and time is a pain.

Thank you for the well wishes. Surgery went great and they removed it before it ruptured. He and mom are back at home while I watch another play baseball.

The general surgeons in town would be happy to do pediatric appendicitis surgery. It's the hospitals that are the resistance points. I covered the why in my prior post.

The evidence is very clear that pediatric inpatient outcomes are much better in pediatric hospitals that do that work day in and day out. The fact that we have S&W and TCH within a relatively short journey decreases the financial motivation for any healthcare system to start a whole inpatient pediatric service locally, it just does not make any financial or medical sense to start an inpatient pediatric program locally.

Ebrazosag has it right. The real problem is Medicaid is picking the winners. Certain groups get paid well to provide Medicaid services (which is anywhere from 20-50% of pediatric healthcare) and other groups get paid about 50%. The only way to stay financially solvent with pediatric care, especially complex care, is to be in the "winner" group which is TCH & S&W hospital services (not clinic work) and Healthpoint. It is not fair and it stifles growth and innovation but that is what the ACA established years ago.

Since St Jo stopped providing pediatric care I've learned first hand that they refuse to see any previously established medicaid children in urgent care and refer them to the ER. They will see insurance patients in urgent care. It is all about $$$ and it is a mess.

We were transferred in May from St Joe's in Bryan to TCH in houston for an issue that resolved on its own before we even left Bryan. The docs at TCH were shocked that anyone would transfer us there, and said it was a giant waste of their time and our money and said the ER docs in BCS are "incompetent morons" (their words, not mine). Man- we felt like ****, and it was a BIG bill out of pocket. Thankfully, a urologist with St Joe's in Bryan said he was willing to see my 10 year old because it was a fairly minor issue and he didnt see the point in us having to drive to Houston for it (especially when TCH doesn't take ANY marketplace insurance- yeah, that initial bill was super fun especially when we pay good money for a good plan with a low deductible and we cant even use it, and now cant use it at the pediatrician we have seen for almost a decade).

Anyways- just to say you are not alone in your frustrations OP.

Edit- and for those going the cash pay route for TCH/UPA pediatrics now- check your bill. We were billed twice what we were quoted, and Houston (where all the billing goes through) said they have no idea why college station would quote the amount we initially paid, and that i owed them an additional $100 for the appointment.

And I promise you the insurance company is using AI to do the denial and not telling you anything about that. While I have to inform you by statute that I'm using AI for a scribe…..thank you Texas Ledge.

ukbb2003 said:

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EBrazosAg said:

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EMTALA affects all er to er transfers which is what the OP described. One doesn't go from one hospital er to another's OR directly.

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Correct, we went from Premier ER in Bryan to TCH Woodlands.

And for the record, I love TCH and S&W in Temple. The same kid has been life-flighted to TCH in Houston and taken another ambulance to S&W in Temple. He has received great care. Still the added cost and and time is a pain.

Thank you for the well wishes. Surgery went great and they removed it before it ruptured. He and mom are back at home while I watch another play baseball.

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I have to wonder if the issue was using an independent ER versus St. Joes or SW?

threecatcorner said:

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What's their excuse for it taking 2-3 weeks for mail and only giving you 3 weeks to appeal?

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No excuse was given. When my wife said to the insurance person on the phone what if we only had a couple of days to file the appeal, they stated "that's not my problem".

The adage of "every patient that gets cured is a customer lost" is real. They would rather we keep pumping our kid full of meds for ADHD, ticks and mood than do something that might actually fix the root cause.