By Lowell R. Quenemoen, M.D.
The Capital of the Commonwealth is home to a progressive expanding medical community serving Frankfort’s 27,000 residents as well as a larger catchment area of Franklin, Anderson and portions of Shelby, Owen, Woodford and Scott counties. Over 150 providers serve the community. Of these 25% are hospital based (ER, Hospitalists, Pathology, Radiology and Anesthesia). Primary care (Family Practice, Pediatrics and Internal Medicine) compromise 35%, Women’s Health 10%, Medical subspecialties 10% and Surgery and Surgical subspecialties 15%.
It’s of note that most of these providers have maintained the independence of soloists or small single specialty practices. However, an increasing number of nurse practitioners and physician assistants are being included as the increasing demands for medical care and the Affordable Care Act impact services. As overhead costs rise there has been an increased partnering with hospitals regarding billing and personnel. Many of the hospital based providers are independent contracted groups giving them autonomy in hiring new partners and in divisions of labor.
Although most areas of medicine and surgery are well covered, the proximity of Lexington (30 miles) and Louisville (45 miles) ease the emergent referral of more complex cases to the University or larger medical centers. The FRMC has on-site helicopter and ground transport services.
The current nucleus of the medical community, Frankfort Regional Medical Center, started life in its current location as King’s Daughters Memorial Hospital in 1974 replacing a smaller downtown facility. The origin of the local hospital movement dates back to 1894 when fourteen women organized to provide charity care.
Opening in 1974 it was licensed for 130 beds but over the next few years grew to 157 beds (now licensed for 173 beds). In 1993 a new ER and outpatient unit were added and the name changed to Frankfort Regional Medical Center (FRMC). This is now a for-profit hospital operated by the Hospital Corporation of America. Ties with the larger corporation have streamlined the process of initiating and funding new projects, centralizing billing and more quickly adapting to the requirements of new healthcare legislation. As a for-profit it also means that tax dollars are going back into the local community.
Over the next 10 years (1999-2008) a Women’s Health Center, a 10 bed ICU, a new surgical center with two new OR’s (now with 6 operating rooms and a cysto suite) a Medical Pavilion adding on-site medical offices and a new 4 bed Neonatal Intensive Care Unit (NICU) were added. In 2010 FRMC joined the University of Kentucky Markey Cancer Center Affiliate Network followed by a venture with Kosair Children’s Hospital Outpatient Center. In 2013 a new ER opened with expansion from eighteen to twenty-eight beds with a new 64 slice rapid CT scanner immediately adjacent.
The year 2013 also included the designation of FRMC as a Level III Trauma Center. Led by Dr, Steve Vallance, Trauma Surgeon, a group of general surgeons, ER physicians, orthopedists and internists organized to meet the requirements of the American College of Surgeons for certification. This means that FRMC can cover the basic stabilization of care as well as further required care in about 50% to 60% of the cases which are often blunt trauma i.e. industrial and auto accidents etc. More complex cases often including head or spinal trauma are transferred to Level I centers at either U of K or U of Louisville. Other Level III centers include Ephraim McDowell Hospital in Danville and Taylor Hospital in Campbellsville.
This past year the Invasive Cardiology Lab provided emergency and elective angioplasty to over 100 patients. This is often a lifesaving procedure in the face of an acute evolving myocardial infarction. The availability of Dr. Mart Denny, an interventional cardiologist and new resident to the community has permitted faster access.
Chip Peal, CEO of FRMC, revealed that the next major project to be completed by mid 2015 will be a new twelve bed geriatric psychiatry unit in the hospital supervised by a staff psychiatrist. Currently residential psychiatric care is provided outside of Frankfort at Eastern Psychiatric Hospital or The Ridge in Lexington.
Recent awards to the center have included Magnet designation which is a national program in nursing excellence, recognition as a Top Hospital and an “A” rating on patient safety by The Leapfrog Group, Top Performer on Key Quality Measurement by the Joint Commission of Hospitals and Commission on Cancer Accreditation by the American College of Surgeons.
In spite of accelerating changes in health care, multiple new government regulations and the unknown long term impact of the Affordable Care Act, there is a strong sense of optimism in the people interviewed for this article. Dr. Mark Myers, Orthopedic Spine Surgeon and a 20 year provider of care in the community, credits much of this to the vision of FRMC administration and its CEO, Chip Peal. Dr. Steve Vallance notes that over the past year the number of insured patients who now have broader access to specialized care has increased, easing some of the financial stresses to the system. For Tammy Payton, Director of Physician Relations and Brad Wands, Director of Business Development, the quality of local services has evolved from progressive care programs, patient education and well trained available providers, According to Ms. Payton, its more than a job, it’s community!