PRATTVILLE, Ala. — James Corder, a doctor at DCH Regional Medical Center in Tuscaloosa, said Wednesday that the availability of interventional radiology services at DCH recently underwent a “drastic reduction,” a change he feared would impact general surgical services at the hospital.
Corder, who described the news as upsetting, shared the change in interventional radiology service availability during a meeting of the Statewide Trauma and Health Systems Advisory Council.
With close to 600 beds, DCH is Alabama’s fourth largest hospital, and the largest in the state’s Black Belt region, which has historically suffered from a lack of access to medical care.
For many residents, including those of neighboring counties like Pickens County, which currently does not have a hospital, DCH is the only hospital within an hour’s driving distance.
Unlike diagnostic radiology, which is primarily used to diagnose diseases and injuries, interventional radiology involves procedures like biopsies and angiograms to diagnose and treat conditions.
“A couple weeks ago, we received an email from our administration that we’ve had a drastic reduction in the availability of interventional radiology services at our hospital,” Corder said.
“They’re going to be available during the week, but we’ve always had 24/7 coverage, and this is a new change for us. It affects all of our surgical services, especially the trauma services, as well as general surgical services, so we’re obviously upset by that.”
Dr. Scott Harris, Alabama’s State Health Officer, asked if the change was temporary.
“That is the new normal, they’ve apparently been negotiating this for a while,” Corder responded.
Jackie Jones, assistant radiology director at DCH, confirmed with ADN that the change in service availability was effective starting June 1, and that it was enacted to both maximize the hospital’s resources, and to respond to recruitment difficulties that had been exacerbated since the COVID pandemic.
“We’re just looking at the fact that there’s a shortage of radiologists nationwide, and they’re definitely recruitment issues with trying to get radiologists in to do these services,” Jones told ADN.
“So we ran some statistics for the past year, and the statistics showed that we did not have a large amount of patients that we were doing after hours. Granted, we do want to keep our patients safe, but we wanted to maximize our resources.”
Harris noted that operating with a more limited access to interventional radiology services would likely “make it challenging to care for people,” and offered Corder his condolences for having to manage the new change.
Radiology services are used in a wide range of diagnostic and surgical procedures, and are crucial for emergency departments, with a study by the Journal of the American College of Radiology finding that radiology services are used in more than 40% of emergency room visits.
Rep. Curtis Travis, a Democratic state lawmaker who represents Tuscaloosa, said he had spoken with DCH CEO Katrina Keefer after learning of the availability reduction of interventional radiology services, and relayed to Alabama Daily News that the cut was likely done as a cost-saving measure.
Similar to Corder’s evaluation of the situation, Travis also named Medicaid reimbursement rates as the likely culprit for the reduced availability of services.
“In a community like Tuscaloosa, it’s hard to recruit those specialists like that because you’ve got a lot of larger areas that can compete for them and pay them better money,” Travis said.
“They’re kind of like the football player, like your quarterback or receiver, they can demand more money in their position, and I’ve heard that previously from the (Alabama) Medical Association that it’s hard to recruit those types of specialists, even in a little community like Tuscaloosa.”
One solution, Travis suggested and has long advocated for, was for the state to expand its Medicaid program, with Alabama being one of ten states yet to do so.
Relating to reimbursement rates, a study produced by the nonprofit organization KFF found that in states that expanded their Medicaid programs, hospitals experienced higher reimbursements for Medicaid patients, reimbursements that “outweighed increases in unreimbursed Medicaid care for a net positive effect.”
While Democratic lawmakers have long advocated for Medicaid expansion, which in Alabama would see nearly 300,000 additional Alabamians become eligible for the program, Republican state lawmakers have recently expressed an openness to the idea, albeit through a private-public partnership model.
The authority to expand Alabama’s Medicaid program lies solely with the governor, however, with Gov. Kay Ivey’s office last month reaffirming to ADN that she still held concerns over expansion related to long-term costs.