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Emerging Riley specialty to look for more doctors: Hospital emergency department sees rapid growth

May 22, 2006

Riley Hospital for Children is looking for a few good doctors to man its bulkedup Emergency Department, the latest sign of the swelling national demand for pediatric ER services.

Indianapolis-based Emergency Medical Group Inc. will take over management of Riley's Emergency Department July 1 and bring in a new medical director, Dr. Bob Collins.

He, in turn, might hire as many as seven doctors trained in pediatric emergency medicine over the next few years, some of whom may replace physicians on the current staff of seven, said Dr. Ora Pescovitz, Riley's CEO.

Pediatric emergency care has grown at a rapid clip in recent years, driven in part by heightened awareness of the specialty. Increasingly, pediatric ER departments are treating children's emergencies that traditional hospital emergency rooms once handled.

In Riley's case, patient visits have shot up 47 percent since 2001. Visits to the emergency room of an Indianapolis competitor, St. Vincent Children's Hospital, have increased at a similar rate.

"I think people have realized that general emergency care systems haven't always met the needs of specialized populations. Kids are not small adults," said Steven Krug, a Chicago doctor and chairman of the committee on pediatric emergency medicine for the American Academy of Pediatrics.

Riley completed a $4.2 million Emergency Department expansion last year. The expansion will allow the department to accommodate 35,000 annual visits, more than double last year's total.

The additional doctors will help staff that extra space, Pescovitz said. The hospital has been managing its ER in-house, with staff primarily specializing in pediatrics.

Adding doctors with the additional training is necessary because Riley handles some of the most severe cases of any children's hospital in the country, Pescovitz said. For instance, a patient arriving at Riley with possible appendicitis might be suffering from a leukemia relapse as well.

"There's specialized training that's really required to offer children the kind of care they need and deserve," Pescovitz said.

Emergency Medical Group is a subsidiary of Clarian Health Partners, the hospital network that includes Riley. EMG already runs the emergency departments at several other hospitals in Clarian's network, including Methodist Hospital.

Methodist's ER recorded nearly 7,000 more pediatric visits last year than the 16,055 Riley received, spokesman Jon Mills said.

"It makes sense to have the same level of medical delivery and expertise at both locations," he said.

The expansion and new management for Riley's ER are part of the $500 million investment plan Clarian outlined last year for the children's hospital.

Some details for the new Emergency Department approach-which was devised with help from the IU School of Medicine's departments of pediatrics and emergency medicine-have yet to be finalized.

The number of doctors added depends on growth, Pescovitz said.

Nationally, hospitals are seeing rapid growth in the specialty, spurred in part by an increase in the number of pediatric-emergency-trained physicians coming out of medical schools, said Ed Parkhurst, a principal with Illinois-based Prism Healthcare Consulting.

Parkhurst said medical professionals have become more attuned to the needs of children. For instance, kids normally arrive at any medical facility filled with anxiety. It comforts them, he said, "to be in an area that's developed especially for the pediatric patient."

Greater awareness among consumers of the emergency departments is another factor fueling growth, said Pescovitz and Dr. Jason Little of St. Vincent Children's Hospital.

Convenience also plays a role. Little said families where both parents work during the day find pediatric emergency rooms a convenient alternative that fits with their busy schedules.

"The emergency room's open when their doctor is not," he said.

The trend helps assure quality medical care, Little added. Pediatric emergency departments offer doctors a chance to narrow their focus and grow proficient in one area.

"That's the way medicine goes now," he said. "It's specialized because there's so much to know about everything."
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