Change is just a few months away in the Brooks Memorial Hospital Emergency Department.

According to a memo sent by Interim CEO J. Gary Rhodes on Dec. 31 to management, staff and the board of trustees, a decision was made to terminate the contract with current emergency department doctors firm, Professional Emergency Services, and contract with ECI Healthcare Partners as of July 1.

A copy of the memo was given to the OBSERVER by a staff member.

The memo states the reasons for the change as “consistently scored near the bottom with patient satisfaction compared to peer hospitals,” “over 2 percent of patients leaving the emergency department without being seen” and a “number of patients being transferred out of the emergency department to other facilities.”

In addition to stating that these factors have a “negative financial impact,” the memo goes on to say PES has been inflexible.

“Our attempts to align our needs with that of the current emergency department group have been rather futile and have led us to explore other options,” Rhodes stated in the memo.

ECI Healthcare Partners was founded in 1972 and is based out of Traverse City, Mich. It provides emergency and hospitalist doctor services for facilities in 30 states including hospitals and urgent care facilities in Ithaca, Cortland, Oswego, Center Square and Fulton in New York.

The OBSERVER spoke with Sheila Walier, M.S., director of Marketing and Community Relations, at Brooks regarding the memo. She requested the paper write out its questions which would be forwarded to Rhodes.

In an e-mail response, Rhodes stated, “To better serve our patients and succeed in an increasingly competitive health care market, the board of Brooks Memorial Hospital has hired a new partner, ECI Healthcare Partners, to manage our emergency departments, effective July 1, 2015.

“ECI is an independent and highly regarded manager of emergency departments nationwide. We expect that the result will be better service for our patients with higher levels of patient satisfaction and enhanced quality, while embracing our philosophy of keeping care local. We will share other details as appropriate as we work through this transition with our employees.”

Prompted by the memo, one anonymous employee sent a reply to Rhodes and circulated it to other hospital employees.

This response takes issue with the reasoning for the change, stating that current emergency room doctors are not to blame for the low satisfaction rating, patients leaving untreated or transfers.

Noting that patient satisfaction is “multi-factorial,” the author of the letter believes the emergency department’s “chronically poor staffing” is to blame, emphasizing a “giant pile of Protest of Assignment forms,” which allow staff to take on larger patient loads.

“Excellent care cannot be provided when the department is struggling to keep their heads above water with the bare minimum – and at many times dangerously less than the bare minimum – of staff present to see to patient care. … When staff cannot devote the necessary and deserved time to each patient because the demand of the whole department takes priority over the individual patient, ratings suffer,” the letter stated.

In addition, the writer points out that the patients that leave unseen are not likely to be in critical need. It says, most likely these patients are using the emergency department instead of a primary care physician or seeking narcotics.

Brooks Emergency Department uses a triage system to see patients, so the most acute cases are seen first. This means that less critical cases may have to wait longer to be seen.

The employee points to further understaffing of internal medicine doctors and surgeons as well as these accepting doctors reluctance to accept patients as the reasoning for the number of transfers.

“The ER doctors can try to admit patients to the hospital, but if the Internal Medicine doctors or surgeons will not accept them, what choice do the ER doctors have? None. The patient has to be taken care of,” the letter says.

In conclusion the writer states a concern that the board-certified doctors currently working at Brooks will be replaced by locum – temporary, fill-in – staff, which could cause instability in the department.

PES took over operation of Brooks’ emergency department in October 2012 after FDR Medical Services accepted a different contract in Buffalo.

The writer recalled that transition and the difficulties the locum doctors posed for staff and patients.

Rhodes did not respond to specific questions pertaining to the qualifications of ECI Healthcare Partners’ doctors, the level of staffing of the emergency department and admitting doctors and surgeons or the nature of the cases unseen in the emergency department.