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 In a surprise move, the Division of Certificate of Public Need has recommended approval for both Doctors Hospital of Williamsburg and for six additional beds at Sentara Williamsburg Regional Medical Center.Williamsburg Fire Chief T.K. “Buzz”Weiler supports Doctors Hospital because he believes it’s important to have another emergency Room in the area. 

The other surprise was the speed of the recommendation, which came Monday after a public hearing last Thursday. Growth won the day. Both applications anticipate significant population growth that could lead to demand for more hospital beds by 2011. Public support was also credited for carrying Riverside.

“This is a significant positive step for us,” said David Tate, Riverside’s senior vice president for development and point man on Doctors Hospital. Tate remained cautious about whether the recommendation would sway health commissioner Dr. Karen Remley, who is expected to decide by February The Division of Certificate of Public Need recommended approval of Riverside’s first Doctors Hospital application in 2005. But Dr. Robert Stroube, then the state’s health commissioner, denied the hospital. “We have no way of knowing,” Tate said of how the recommendation will sway the health commissioner. “We do believe it carries significant weight with the health commissioner, but at the end of the day it’s at her discretion.”

The Doctors Hospital blessing has not changed the mind of Sentara Williamsburg administrator Robert Graves, who hinted he’ll continue to press his case for only one hospital. “The staff recommendation is one step of a multi-phased process, and we’re reviewing the staff analysis to prepare for the next step,” Graves said in a brief statement Tuesday. “We’re convinced, however, that our communities are better served in today’s challenging economic environment by a brand new, existing hospital with 40% available capacity, than another hospital that will cost millions to build and operate.”

Doctors Hospital seeks 30 medical-surgical beds and 10 intensive-care beds. The two-story, $84 million hospital would be located on 30 acres as part of Riverside’s Quarterpath at Williamsburg development. All 40 beds would be shifted from Riverside Regional Medical Center in Newport News, refuting the argument about too many underutilized beds. An additional 20 beds at Riverside Regional would be closed.

Sentara seeks six additional medical-surgical beds at Sentara Williamsburg Regional Medical Center. That would require building a sixth floor at a cost of $11.4 million vs. $84 million for Doctors Hospital.

A written report on the recommendations noted that the costs to build Doctors Hospital and Sentara’s proposal to erect a sixth floor are the “highest of any project recently reviewed by the Division of Certificate of Public Need.”

The Division of COPN did credit Riverside with moving 40 beds from Riverside Regional and closing 20 additional beds, saying that the avoidance of creating new beds in the region would result in a savings of around $38 million.

“The proposed project is the least costly and most effective alternative available,” the recommendation reads.

The growing population, particularly senior citizens, also factored into the recommendation to approve both proposals. The division noted that at the current rate of growth in medical-surgical inpatient days at Sentara Williamsburg, the occupancy rate of the existing 106 beds would be close to 90% by 2011, the year the six new beds would come on line.

Even with the new beds, Sentara’s occupancy of medical-surgical beds would be 85%. If approved, Doctors Hospital would not open until 2012. The COPN division also recognized the “overwhelming” public support for Doctors Hospital and that a second hospital would help promote competition in the health care market in greater Williamsburg. Both points are part of new criteria the health commissioner must consider when deciding on health facilities.

The recommendation focused at length on competition, saying that “a single provider lacks many of the incentives that may improve and enhance services to the market. Without an alternative, residents accept an array of services as determined by the hospital operator. Without an alternative, thirdparty payers have limited negotiating leverage. Without an alternative, residents cannot reward the provider that best meets their health care needs.”

Riverside’s breakthrough is a blow to Sentara Williamsburg even though the latter won its dueling application for more beds.

The approval of Doctors Hospital validates that Sentara moved too far out of town, since access is a factor in the COPN criteria.

Riverside, in its application for Doctors Hospital, projected traffic accidents along Interstate 64 by the year 2015 to argue that backups would slow ambulance and other emergency traffic to Sentara Williamsburg.

Approval would restore an Emergency Room to the city ’round the clock, which many consider invaluable for the hundreds of thousands of tourists who stream in each year.

“There will be more and more traffic on the eastern side of town,” he said. “And it’s not just Williamsburg, it’s also this end of York County.”

He said Sentara is difficult to access. “We have had some problems. We don’t have a lot of options to get there, depending upon where the patient is.” Weiler said the fire department avoids transporting patients on 64 or on Mooretown Road, adding that he had not seen, but was not surprised by, the accident statistics used by Riverside. “You know what the interstate is like,”Weiler said. “Mooretown Road has no shoulder and is very twisty and turny. It also runs through residential developments with children, who are attracted to sirens. The last thing we want is a kid on a bike to ride out in front of an emergency vehicle trying to see what’s going on.”

He said a second Emergency Room would greatly improve transport times. “I’d say that for more than 50 percent of the city, an Emergency Room on the east end of town would lead to faster transport times.”

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