The second edition of a debate over an upgraded Methodist Healthcare trauma center in San Antonio continues to worry city and county leaders, even catching the lingering attention of Pentagon officials.
The crux of the debate is whether Methodist upgrading from a Level III trauma center to the higher Level II will impact Brooke Army Medical Center and its military medical readiness mission.
San Antonio is home to two Level I trauma centers able to handle the most complex injuries: University Hospital in the South Texas Medical Center and BAMC on the northeast side of town.
Last month, city leaders were informed that Methodist Healthcare, the largest hospital system in San Antonio, was considering upgrading the trauma designation of its flagship hospital in the medical center.
Officials from the City of San Antonio, military community and University Health expressed concern over how the change would impact BAMC and its ability to train military physicians.
“The military, though, is very concerned. Very, very concerned. They love it here, so they don’t want to have to uproot everyone,” said Councilwoman Misty Spears (D9) in an interview with the San Antonio Report.
BAMC is the sole Level I trauma center in the entire U.S. Department of Defense network, though it does not exclusively treat military personnel.
Last month, a city council committee debated a resolution expressing support for BAMC’s unique place in the medical ecosystem and the city’s military missions, which questioned some of the specifics of Methodist Healthcare’s plans.
The resolution was tabled after some members expressed concern over what will provide the best patient care for San Antonians.
Bexar County Commissioners Court will consider a similar resolution on Tuesday. The Bexar County Hospital District Board of Managers is expected to be present at the meeting to speak on the resolution.
Spears said in less than one month she, Commissioner Grant Moody and retired Maj. Gen. Scott Jackson, the director of the city’s Military and Veterans Affairs Department, have traveled to D.C. twice and heard from Pentagon leaders about the issue.
“Under no circumstances does it work for them to lose their patient volume and complexity,” Spears said of BAMC.
Level I facilities must see a certain number of patients to maintain their certifications, and a new Level II center in the city could decrease the total number of trauma patients BAMC sees. Jackson said last month that trauma cases in the area have been decreasing over the last two years.
Spears said the group met with Undersecretary of War for Health Affairs, Keith Bass, and surgeon generals for the U.S. military branches. Pentagon officials expressed concerns that if BAMC were to lose capacity, they may have to consider upgrading a different Defense Department hospital to the Level I designation.
“There was there was some discussion about which facilities could potentially meet those needs,” Spears said.
The hospital, which has long been seen as a global gem for its hostage reintegration program and burn center, also trains and teaches military personnel, and has helped make San Antonio the home of military medicine as the department’s only Level I trauma center.
The city currently has no Level II facilities, which has resulted in Methodist at times having to transfer patients to higher designation hospitals. Some councilmembers expressed concern about this.
“For me, the goal is San Antonio residents and others get the quickest care that they can, not have to go to Austin, not have to go to Houston,” said District 7 Councilmember Marina Alderete Gavito at the Sept. 29 meeting.
Spears said she is expecting more Pentagon support as the debate continues.
“We did express to Secretary Bass that we needed his support, so we’re expecting some letters to come from him and the surgeon generals,” Spears said.
Jackson said at the meeting last month that he was notified in August of Methodist’s plans to apply for upgraded status on Oct. 1.
However, as of Friday, the Texas Department of State Health Services, which handles trauma designations, said Methodist has yet to apply for a new status.
In 2017, Methodist sought Level II status, only to receive pushback from the military medical community over the same concern about BAMC’s case volume.
It is unclear if the hospital will move forward with the upgrade because they do not need city permission to do so.
Both Methodist and the Southwest Texas Regional Advisory Council (STRAC), which coordinates trauma care in the region, did not respond to interview requests.
The debate seems to have stuck a nerve with the city’s military leaders, who are keen on not losing any more military might.
The official shuttering of Army North and South this year was a move that military leaders hope is, an isolated one and not the beginning of more closures.
The San Antonio Report’s military and veterans coverage is supported by Report for America.
