By Jeff Mays
HARLEM — Wearing white lab coats, chanting and holding protest signs, dozens of doctors and staff at Harlem Hospital protested layoffs scheduled for the end of the year while local politicians promised to fight the cuts.
Marching across the street from the hospital, doctors said the planned layoff of 41 employees, including 13 doctors, by Dec. 31 and the end of Columbia University's financial affiliation with the hospital could throw the public hospital into turmoil and mean everything from worse care to longer waits for patients and the loss of the hospital's certification as a Level 1 trauma unit and teaching facility.
"You save lives that save a nation and save a world," said the Rev. Al Sharpton after recounting how Martin Luther King Jr. was once a patient at the hospital. "We don't know who the Harlem doctors may be saving that will go on to do great things."
In an effort to close a $1.3 billion budget gap, the Health and Hospitals Corporation announced a massive restructuring in May. The changes included layoffs in addition to combining services, and a restructuring of the affiliations of the 11 hospitals that HHC oversees. Columbia University will end its financial affiliation with Harlem Hospital, as a result.
HHC officials say the shortage is due to a reduction in federal aid and state Medicaid funding and a major increase in pension and medical insurance costs for employees. By 2014, HHC will have reduced its overall staff of 38,000 by 10 percent.
But Rep. Charles Rangel questioned the process by which financial oversight of the hospital will be transferred from Columbia University to a non-profit entity.
"We better find out how all of this started," said Rangel. "What makes Harlem Hospital so great is the prestige of Columbia University and the confidence the community had in them. They are chipping away at this block by block."
Former Mayor David Dinkins recalled rushing his child to Harlem Hospital when he lived in the area. Assemblymen Keith Wright waved to his doctor in the crowd and recalled how health care providers at the hospital saved his father's life after a heart attack. Dr. Barry Liebowitz, president of Doctors Council SEIU, the union that represents doctors at Harlem Hospital, recalled how his son was brought to Harlem Hospital after suffering head trauma in a car accident.
"This hospital is a beacon but you can't run it with brick and mortar. You need people. You need doctors," Liebowitz said. "We are here to fight the most important fight and that's for the survival of this hospital."
Brooklyn Councilman Charles Barron, who is running for governor on the newly formed Freedom Party ticket, called on Mayor Michael Bloomberg to intervene and find the money to help prevent layoffs by dipping into the city's "rainy day" fund.
"The mayor said he's waiting for a rainy day. Well mayor, its raining," said Barron.
HHC officials have said the cuts were designed to have the least impact on patient care. In an open letter to the public, Harlem Hospital Executive Director John Palmer said the hospital will maintain its academic relationship with Columbia University and remains committed to the community with the $300 million Harlem Hospital Center expected to open in 2012.
"I want to set the record straight: Harlem Hospital Center will continue its strong and unwavering commitment to the community, our patients, and the men and women who work at this extraordinary health care facility," Palmer wrote."
Dr. Matthew Hurley, vice president of Doctors Council SEIU, has worked at Harlem Hospital for 25 years. He said that the 23 vacant doctor positions have remained unfilled for a year. Combined with the layoffs and the loss of another 25 to 30 doctors who see the changes as a good time to retire or move on, patient care is in jeopardy.
Some specialties, such as neurosurgery, already have only two doctors who are concerned that their workload is going to become even heavier, "putting their licenses in jeopardy," Hurley said.
"We have been weened down to a significant degree already for a long time. Now, the rapid pullot of Columbia has forced people to think about taking their retirement now," he said.
Dr. Carol McLean-Long, an internist at Harlem Hospital and a Harlem resident said that Harlem Hospital is even more important now because Harlem is in a period of transition with the rich and poor.
"The rich have the ability to travel downtown for care. But this is where poor people come for their surgeries, cardiac catheterization labs, and rehabilitation. This is where the poor come for their lives to be saved," said McLean-Long.
All of this comes as Harlem Hospital has seen a 10 percent increase in admissions since North General Hospital closed, Hurley said. In addition, the licensing examinations required for Harlem Hospital to maintain its trauma level status and teaching credentials are imminent.
Shivanck Udadhyay, the delegate for the Committee of Interns and Residents at Harlem Hospital said residents like himself are concerned about the quality of teaching that will be available once Columbia University alters its affiliation agreement with the hospital.
"Right now, Columbia is a University with senior professors with a lot of knowledge who supervise our learning. If a different entity is providing the doctors we are not sure if the quality of the teaching will be less," said Udadhyay, a third-year internal medicine resident. "We practice what we know. And we know what we are taught."
Last year, HHC facilities served 1.3 million New Yorkers, 450,000 of whom were uninsured.
"They'd better not cut this hospital. This is a good hospital that we need in Harlem," said 65-year-old Rosemary Ginte as she headed in to Harlem Hospital for an appointment.
Another patient, Carlos Mauleon, 56, of Harlem, uses a motorized wheelchair and said the cuts worried him.
"If there are cuts, it will only hurt the community more. I'm in a wheelchair and I may have to come in here for an emergency but because of the cuts I may not get the help I need," said Mauleon. "This is the only hospital that caters to us, the brothers and sisters of Harlem, in our own neighborhood."