Cook health-care cuts feared - No part of system will be untouched, interim leader says

By Judith Graham
Chicago Tribune
January 9, 2007

As many as a dozen community-based medical centers for needy residents could close if budget cuts proposed by Cook County Board President Todd Stroger are enacted this year, sources said Monday.

Labor and delivery services at Provident Hospital could be eliminated. And already-stretched specialty clinics at Stroger Hospital could be cut back, the sources said.

Job cuts will be widespread, and no part of the Cook County health system will be spared, the new interim chief of the system, Dr. Robert Simon, told hundreds of employees at a meeting early Monday, according to several people at the gathering.

Any service not critical to the mission of the county's health system is vulnerable to being downsized or eliminated, Simon said, according to those in attendance.

As Cook County contemplates a proposed 17 percent budget cut across departments to eliminate a budget deficit, a sense of crisis has descended on its enormous health care system.

The county's medical services for the poor and people with no health insurance will "be devastated by cuts of this magnitude," said Dr. Peter Orris, a senior attending physician at Stroger Hospital and past president of the medical staff.

"We're busting at the seams already, and this is going to push us over the edge," said Martese Chism, a union official and medical surgical nurse at Stroger.

Although Monday's meeting was short on specifics, "they're talking about laying off significant numbers of doctors, and everyone is very depressed and very insecure," Orris said, adding that he knows of physicians who have already begun looking for jobs elsewhere.

"If you close clinics or portions of certain hospitals, where are people going to go to get care?" said Jim Pandazides, a critical care nurse at Stroger Hospital.

Decisions likely will be made in the next week, before Stroger delivers his budget proposal to the Cook County Board, said Steve Mayberry, the board president's spokesman.

"We recognize that public safety and public health are our core missions. But in every area, there will be cuts of some sort, and there will likely be a large hit in the area of personnel," Mayberry said.

The timetable is extraordinary, given the revolving-door leadership at the county's health system. Simon was appointed just over a week ago, becoming the third physician to become interim chief of the health system since the sudden departure of Dr. Daniel Winship in November. Previously, he was executive chairman of emergency medicine at Cook County.

Simon reportedly has pulled together a team of experts to advise him, but they have to work at breakneck speed, without customary in-depth deliberations. At Monday's meeting, Simon said he alone would be responsible for coming up with a final plan for proposed cuts.

Meanwhile, more than 200 doctors filed a petition Friday with the Illinois State Labor Board seeking to form a union that would give county physicians stronger negotiating clout.

"Sadly, there is no vehicle for frontline doctors to be heard collectively and to sit at the table" with officials who are making plans for the health system's future, Orris said.

Altogether, about 500 doctors are employed by Stroger Hospital, about 100 are on the staff at Provident, and another 86 work at the Cook County Jail or in community-based medical clinics.

Currently, physicians at Stroger and Provident work without employment contracts. About 50 doctors at Oak Forest Hospital organized a union several years ago.