Franklin Square Pediatrics - FAQ

Is this just about former staff feeling bitter after their termination?

A:

All fired staff have already found jobs and are serving patients elsewhere. They are taking action out of deep concern for the effect that these closures will have on the community they served, and not out of self-interest. Some staff members who have spoken out are not among those who were fired and remain at Franklin Square Medical Center.

“I'm not doing this to complain about my job. With this particular mistake, I truly believe that we’re going to have very bad outcomes. It’s very, very concerning for these kids.” 
-Dr. Anna Reed, former pediatrician at Franklin Square

Medstar Franklin Square will continue to treat pediatric patients as in the past, just in a combined emergency ward by pediatricians and emergency physicians.

Medstar's response to community outcry has been to frame the pediatric ward closure as a minor adjustment of a small ward, even though 8 pediatricians and 38 supporting staff were terminated as part of this move. Medstar has repeatedly defended its capacity to provide emergency pediatric care at Franklin Square. 

A:

Contrary to the assertions of professional administrators and PR specialists who do not have a background of providing pediatric care to the community, current and former staff members who do have that experience of responsibility have raised serious concerns about Franklin Square's ability to provide emergency care for children. Current and former staff, as well as local families, say that there have already been near misses that put have children in danger.

"The fallout from this has been nothing short from a public safety disaster. The MSFSMC adult ER providers were asked to assume the role of experienced emergency pediatric providers without recent experience to do so as the pediatric ER was in a separate space. Friday morning, April 6th, they were learning PALS – Pediatric Advanced Life Support, normally, a two day class. The adult ER nurses and medical technicians are untrained, unprepared, and terrified. Many had not seen a pediatric patient in over a decade and yet now the life of the blue newborn that is brought in by ambulance rests in their hands.  Over the years, many older pediatric patients without life-threatening conditions were seen by adult ER providers, but critically ill infants and toddlers were treated and managed by pediatricians."
Dr. Anna Reed, former pediatrician at Medstar Franklin Square

"We have near misses every day here. We do not have the dedicated, credentialed, trained clinicians and staff going down from doctors, nurses, techs even down to the unit secretary that knew what they needed to do to take care of these patients. Pediatric room 17 was a well-oiled machine. When a really sick child came through, everybody assembled, everybody knew what they had to do, and they made sure that was taken care of. This is a disaster." 
-Mary Scott, current staff

"We were there for six hours waiting for my grandson to be diagnosed. And it turned out to be a viral infection. But then we ended up taking him to Bayview which was another 5 hours, but it was worth it because he’s very important like all kids are. And then on the same day that we were here, there was a little four year old that was brought in and they diagnosed her viral infection. Lucky enough, her mother took her to her pediatrician. The child had pneumonia. I’ve known kids that have died from pneumonia... We brought junior here 3 months ago [before the closure] and he had bronchitis. They diagnosed that within an hour and we were already out. And they were bringing other patients in."
-Diana Simmons, local resident

"The moment I heard that the entire department was going to be eviscerated, it broke my heart. Because I knew right away, that meant children were going to be in danger, children who were coming from all over the region, children who were not able to be stabilized by trained professionals like they had been for so many years."
-Dr. Richard Bruno, former resident physician at Medstar Franklin Square Medical Center

"I’m terrified of the next week that there’s a six week old that’s gonna walk into my office with a fever and having trouble breathing and I’m going to have to put him in an ambulance and they’re going to have to drive 20 or 30 minutes across town to see a pediatrician to take care of them. I’m terrified and it’s going to happen either next week, or the week after that, or the week after that. It’s going to happen. I’m terrified somebody’s going to come in with a seizure and they’re going to be taken care of by an emergency room doc who hasn’t taken care of a pediatric patient since they were in residency a decade ago. And they’re going to give them the wrong dose of medication. And there’s no nurse that’s going to catch it since they fired the pediatric nurses.” 
-Medstar Franklin Square Resident Physician

In particular, the removal of staff who were part of the Child Protection Team (CPT), which served as the Baltimore County center for child sexual abuse evaluations and cared for three hundred child survivors each year, is singled out as having dangerous repercussions for local children.

"I'm scared some nine year old is going to come in with a runny nose, and they’re gonna get the perfect care for that runny nose. But nobody’s gonna notice the bruise in the back of their leg that is an early sign of child abuse. That our child abuse team here would have caught up and would have intervened on early before the kid could be put back in danger." 
-Medstar Franklin Square Resident Physician

"The Child Protection Team was dissolved. Firing Dr. Krugman ended the program, and all social workers and covering doctors were terminated as well. No coordination occurred with other hospitals, so the hospitals were calling Dr. Krugman and asking what to do. It is highly likely that children who are physically abused are going to be missed or not reported because of not having a system in place.  Children who are victims of sexual abuse will have to travel far for evaluation."
-Dr. Anna Reed, former pediatrician at Medstar Franklin Square

"Dr. Krugman is a national expert in the area of pediatrics, particularly in the area of physical child abuse. We’ve used him countless times in court and the doctors and nurses and staff here do an excellent job and have formed a great partnership with the Baltimore County state’s attorney’s office in helping our most vulnerable victims and that is the victims of physical and sexual child abuse. And to walk away from that is walking away from this community, and more importantly, not contributing to the community’s benefit. I am very much opposed to them closing this unit. We would implore them to reopen it. Bring Scott Krugman back tomorrow or yesterday. This is really an important feature that we have and that we need here in Baltimore County.

There are some things that you do in a hospital that isn't always about the bottom line. It's about giving back to the community, it's about contributing, it's about not only helping us investigate child abuse cases, but also offering treatment to those children who have been abused both physically and sexually.”
-Baltimore County State’s Attorney Scott Shellenberger

 

Are pediatric emergency wards too costly to maintain?

Medstar claims that as a nonprofit institution with limited funds, it had no choice other than closure.  These actions align to current trends in hospital management and represent the latest innovations in pediatric care.

A:

"In the era of the global budget in the state of Maryland, their reply makes no sense. Our revised all-payer system emphasizes population and community health, which this decision has jeopardized. The pediatric unit was losing about $200K a year, but pediatrics is not a profitable business. And it’s also small change compared to Medstar’s status as a six billion dollar medical system. Ken S, the CEO, has been making $5 million a year. Sam Moskowitz is making $1.2 million."

–Dr. Anna Reed, former pediatrician at Franklin Square

"We have near misses every day here. We do not have the dedicated, credentialed, trained clinicians and staff going down from doctors, nurses, techs even down to the unit secretary that knew what they needed to do to take care of these patients. Pediatric room 17 was a well-oiled machine. When a really sick child came through, everybody assembled, everybody knew what they had to do, and they made sure that was taken care of. This is a disaster."
–Mary Scott

"I have a few questions to Medstar. Before they closed this unit. Did they cut the bonuses of their administrators? Did they do away with any of their jobs? This has to stop. This is a good example of why maybe we might need universal healthcare. Everyone in this state, everyone in this country deserves good quality healthcare that is affordable. Over 50 percent of these children were Medicaid recipients. Is that why they closed this unit? That makes me mad. We care for childcare!" 
–Donna Hines, local resident

"When children are turned around on an observation unit in one or two days and returned to the community and to their homes instead of being admitted to the hospital, it no longer fuels a for-profit machine that can bill for very highly profitable inpatient stays. And so instead of being rewarded for the efficiencies in this system, pediatricians and staff were punished by being fired. And that’s wrong."
–Dr. Richard Bruno, former resident physician at Franklin Square

"I’m not a hospital administrator, I don’t know anything about balance sheets to know what is running in the red or in the black. But at the very least, the community has to be at the table. This was done behind closed doors and it was announced after the decision had been made. And that’s not how an institution like this, that receives hundreds of millions of dollars of public money every single year, should act. It’s not a bakery that can open and close whenever it wants. It’s a hospital. And it happens to take care of a lot of people who don’t have anywhere else to go."
-Resident physician at Franklin Square