Physicians at Community Medical Center release statement on teleheath change

A group of eight pediatric hospitalist physicians who staff the Pediatric Intensive Care Unit at Community Medical Center in Missoula have released a statement clarifying their views on the hospital's decision to end in-person pediatric intensivist coverage in the unit in favor of telehealth via video screen.

Earlier this week, several dozen nurses and respiratory therapists sent an open letter opposing the hospital's decision.

On Wednesday morning, Drs. Lauren Wilson, Laurie Carter, Elizabeth Beil, Hannah Yerxa, Hanna Deutsch, Atty Moriarty, Christopher Jons and Emily Hall sent a letter to the Missoulian explaining the nuances of the situation and their view.

"Our pediatric hospitalist team is saddened that Community Medical Center has made the decision to end in-person pediatric intensivist coverage in our Pediatric Intensive Care Unit," they wrote.

All eight of them are pediatric hospitalists, and they clarified their role.

"Pediatric hospitalists are board-certified pediatricians who focus on the care of acutely ill children and newborns in the hospital," they wrote. "Pediatric intensivists have completed additional fellowship training in critical care, and are the physicians primarily staffing PICUs throughout the country, sometimes with hospitalist support."

They said they have advocated for the past decade to maintain pediatric intensivist staffing.

"The decision to end in-person pediatric intensivist presence was not a decision we were involved in making, nor is it one we would have chosen," the letter continues. "We fully recognize the difficulties of operating a low-volume pediatric intensive care unit. We also recognize how vital a staffed PICU can be for the children of Missoula and its surrounding communities."

They acknowledged that there are many "obstacles facing children's health care" at the moment, including a 33% decline in the number of Montana children covered by Medicaid and the Healthy Montana Kids program since 2023. They noted there's a chronic underfunding of children's services and nationwide shortages of pediatric specialists.

"We know this change will be difficult for our community," the letter says. "While our team is able to care for most children hospitalized in Missoula, more of the very sickest will need to be transferred out to other hospitals. We live here. Most of us have children of our own. We care deeply about our community, and we will continue to work with Community Medical Center’s administration and the pediatric staff at Community Children’s to use every resource we have to provide the best possible care for hospitalized children."

The pediatric hospitalists said they are "profoundly grateful" for the team of dedicated, compassionate nurses, respiratory therapists, physicians and others who staff the pediatric unit and the PICU.

"We have had the privilege of working alongside the pediatric intensivists for years, providing collaborative care, helping with nighttime coverage, and ensuring safe transitions of care," they concluded. "We would fully support the return of the in-person pediatric intensivist coverage if it becomes possible. In the meantime, our team will be here. We’ll continue to provide safe and thoughtful care, day and night, for children who are ill or injured. From Day One."

In a statement earlier this week, Community Medical Center said that the transition to a telehealth model “reflects a sustainable, patient-focused model for providing safe, dependable pediatric critical care while maintaining continuity for both our patients and care teams.”

“Community Medical Center is not eliminating pediatric critical care, we are changing how that care is delivered,” the statement from Community said. “Over the past several years, declining PICU volumes, a trend reflected nationally, have made it increasingly difficult to sustain a traditional, onsite-only staffing model, despite ongoing efforts to recruit pediatric intensivists. Rather than eliminate these services, we have chosen a different path to ensure pediatric critical care remains available to our community while also preserving roles for the dedicated caregivers who provide this care every day.”

A spokesperson for Community did not immediately respond to a request for comment about the letter from the hospitalists on Wednesday.