Instant Clinic for Breast Care - Prefab Hospital in Bucks County is Set to Open in October
By Erika Engelhaupt for The Philidelphia Inquirer


Lickety-split hardly describes it. A wing of patient beds went up in a day. Cranes hoisted 10 pre-built sections onto round foundation piers, like an enormous Erector Set snapping Lego blocks into place.

A prefab unit is hoisted into place onto foundation piers. Such hospitals may someday be used in war and natural-disaster zones. Critics question the need for another area facility. DSI Bucks County, the region's first new hospital in at least a decade, will house a comprehensive breast-care clinic.

Walls inside were already painted, complete with nurse call buttons. Wires hung from the ceilings like nerve fibers ready to light up rooms.

Other area hospitals are nervously keeping an eye on the newcomer. Southeastern Pennsylvania is widely considered "overbedded" already, with more hospital beds than the population may need. Sophisticated cancer care is also widely available, both locally and regionally, at nationally renowned places. And a new facility may be hindered by a small number of cases, because high patient volumes often accompany good quality.

Some fear, in addition, that the new facility will focus on prosperous clients, ignoring the uninsured.

"They'll be right smack in the middle of four other facilities that provide cancer care," said Pamela Clarke, vice president of managed care at the Delaware Valley Healthcare Council, which represents hospitals.

While competition is benefical, she said, "we think it's extremely important that all licensed health facilities have an obligation to provide services to people in need, regardless of their ability to pay."

Responded Tannenbaum: "Our primary focus will be taking care of patients with breast disease, but not to the exclusion of serving this community." He said he expected that the hospital would give free care comparable to national rates.

"Some hospitals may see us as competition, but we're in competition with cancer," said local breast surgeon Beth DuPree, who will be medical director of the Comprehensive Breast Center at the new hospital. DuPree, who also works at nearby St. Mary Medical Center in Langhorne, said that, on Wednesday alone, she diagnosed six women from Bucks County with breast cancer.

Plastic surgeon Robert Skalicky will serve as medical director of the hospital's aesthetic center, which will perform breast reconstructions for cancer patients, as well as cosmetic surgeries.

When complete in October, the 126,000-square-foot hospital will have 24 patient beds, doctors' offices, a breast-imaging center, cancer-treatment facilities, and six operating rooms. It will be owned by the privately held, for-profit DSI. Some of the facility's doctors also invested in the hospital.

DuPree said she hoped to diagnose breast cancer within 48 hours of a patient's arrival, instead of asking her or him to wait up to six or eight weeks, which she said was common. "I want to give them a road map to make the whole process seamless and comprehensive," DuPree said.

This is the first prefabricated hospital unit the state Department of Health has reviewed for safety and fire-code compliance, according to spokesman Richard McGarvey.

As for assessing whether the area needs another hospital, no one is in charge of that.

Until 1997, proposals for new hospitals needed to get a certificate of need from the state to minimize overlap among nearby hospitals. The program was controversial and, some said, subject to political interference. The state legislature did not renew the law.

"As long as they meet [local building codes and zoning] requirements, they can build wherever they want to," McGarvey said.

The new hospital will have an emergency room, but it is not equipped as a trauma center for specialized emergency procedures such as open-heart surgery.

While it is a hospital, DSI Bucks County resembles large specialty clinics, which represent a booming business, springing up for everything from heart surgery to medical imaging, said Mark V. Pauly, professor of health-care systems at the Wharton School of the University of Pennsylvania. Many such clinics profit by accepting well-insured patients or by providing services that have high reimbursement rates from insurance or Medicare, he said.

In 1997, Pennsylvania had about 50 free-standing ambulatory surgery centers. That number shot up to 177 by 2005, according to the Pennsylvania Health Care Cost Containment Council, an independent state agency focused on health quality and costs.

Competition from privately owned specialty clinics "has the potential to have a negative impact on community or general-care hospitals," observed Patrick Knaus, vice president of marketing for nearby St. Mary Medical Center. "They can focus all their time and money on one service line, whereas we focus on the entire needs of the community."

A focus on one service line may be a plus for patients, say the doctors at DSI Bucks County.

"When a woman comes in the door to get a mammogram, we'll read it right there, and if there's a problem, they don't have to come back or go someplace else," Tannenbaum said. "We'll take them right down the hall for their MRI."


Contact Erika Engelhaupt at 215-854-5568 or eengelhaupt@phillynews.com