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City Council on Thursday unanimously passed a resolution emphasizing San Antonio's support for Brooke Army Medical Center (BAMC) and the importance of maintaining the city's military missions.
City and military leaders say one or more private hospital organizations have indicated interest in possibly developing more trauma centers around San Antonio, especially Level I facilities – the highest level of comprehensive service.
San Antonio has two Level I centers – BAMC and University Hospital.
Palmira Arellano, vice president of marketing and public relations for Methodist Healthcare, said the increase in natural disasters and mass casualty events have caused communities nationwide to research the structure of trauma levels within their regions.
"As the largest health system in the region that has a proven record of quality care, it is our obligation to perform a community health needs assessment and help provide resources to meet those needs," Arellano told the Rivard Report. "This includes the assessment and research of appropriate trauma levels in the San Antonio region."
Council's resolution stressed the vital role that BAMC's personnel plays in providing Level I trauma care in the region and training to military medical staff.
Lt. Gen. Jeffrey Buchanan, U.S. Army North commander at Joint Base San Antonio-Fort Sam Houston, said increased competition could reduce the patient load at BAMC and put the facility at risk of relocation elsewhere in the United States in a future round of Base Realignment And Closure (BRAC).
About 85 percent of the patients treated at BAMC in 2016 were civilians, Buchanan told Council, and many of them had no health insurance.
The ability to comprehensively serve the local civilian population while operating a renowned burn center and pursuing educational/research programs make the facility even more important, Buchanan said.
"The federal government is doing this to provide care for our citizens locally," Buchanan explained . "And why, may you ask, [are] they doing it? They don't do it just because of goodness in their heart. They do it because it's absolutely critical for military readiness."
Buchanan said battlefield survival rates in Afghanistan and Iraq have improved due in large part to the training that military physicians, nurses, and other operating room technicians receive at BAMC.
"The Department of Defense invests a lot to bring its doctors down here and get them a lot of repetition in trauma, and they get great experience here," he added. If BAMC's patient load goes down, and with it opportunities for medical staff to practice, the facility's military medical readiness would be jeopardized.
Buchanan said “there are a couple of national level medical associations that have hospitals here in San Antonio – Methodist and Baptist are a couple of them, I don't know if it’s limited to that – but there’s pressure from the national level to actually stand up new trauma centers in San Antonio."
Those major hospital networks "want to do it to make money – It's a good money-making proposition," he added. "I don't begrudge them of that fact, but if they stand up a new trauma center here, it's going to detract from the military medical readiness because it'll take away repetitions that our doctors need to be experienced on the battlefield."
Arellano confirmed that officials from Methodist Healthcare and BAMC have met to discuss "the impact of adding a higher level of trauma care to our region and to discuss any collaboration that may be considered in doing such.
"Our future planning is based on what is best for patient care and what is best for the health and wellness of the communities we serve," Arellano added.
Over the summer, BAMC leaders presented their concerns to the City's Military Transformation Task Force, which recommended that City Council, Bexar County Commissioners, and the San Antonio Chamber of Commerce all adopt resolutions in support for BAMC.
Council members and civilian medical professionals all backed the resolution.
Dr. Byron Hepburn, director of the Military Health Institute at UT Health San Antonio, described BAMC as a national asset that cannot be compromised.
"It's interwoven fabric of high-quality clinical care, research, and educational training at all levels," he told Council.
Mayor Ron Nirenberg said the resolution is a good way for the City to demonstrate support for local military missions and for what is in the community's best interest.
"We have long benefitted from BAMC as a community, and indeed all of South Texas has," he said. "It's a world-class trauma center for our citizens and 22 other countries, and millions of dollars of uncompensated medical care for our citizens.[UT Health San Antonio] benefits from the training opportunities for physicians, nurses and medical technicians.
"In short, BAMC has been an integral part of San Antonio, and we cannot take it for granted."