Gary J. Passama, President and Chief Executive Officer of NorthBay Healthcare System since 1981, is a veteran of more than 40 years in Northern California health care. He has served as faculty and speaker for programs of the American Hospital Association, Hospital Council of Northern California and the Medical Group Management Association. He is a Fellow of the American College of Healthcare Executives.

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Geography Lessons for Thrivers

It's begun. As I predicted, the guys from Oakland are beginning their local advertising campaign to tout their trauma services. Look for them to spend more of their plan members' premium dollars on their expensive PR gambit.

What was absurd and a demonstration of how disconnected the Oakland regime is with local communities was its assertion that they have served Solano County for 65 years. Yes, it is true for Vallejo. But for most of those 65 years the Oakland folks thought Solano County ended at the Vallejo city limits.

It has been NorthBay Healthcare providing health care north and east of Vallejo during those 65 years, including serving those covered by the Oakland health plan when there was an emergency. Even today, if you have no insurance or are covered by Medi-Cal it is NorthBay that accepts a disproportionate share of that responsibility.

It is easy to thrive when you avoid obligations others assume. It is much easier to write a check to a local group for a fraction of what it would cost to open all your services to all who may need it. This is a distinction that many in the public probably do not understand. NorthBay and other providers in the region serve all and are open to all regardless of whether it's an emergency.

On Monday, NorthBay and the Oakland folks submitted proposals asking to be designated Solano's Level 2 trauma center. The county's plan provides that there be two trauma centers, but only one can be a Level 2. Currently both organizations operate Level 3 centers, which capably care for most trauma victims. And two trauma centers for a county this size is more than sufficient.

The primary difference between Level 2 and Level 3 is that Level 2 centers handle serious head injuries. Both organizations now have that ability. NorthBay has an outstanding neurosurgeon, backed up by others, who does both trauma cases and complicated elective cases. When the designation decision is made, all of the emergency neurological injuries will be sent to the Level 2 hospital.

The organization that does not receive the Level 2 designation will continue to be a Level 3 center. And neither will see much reduction in the current volume of cases it sees. That is good for the county's residents.

NorthBay Medical Center, situated best at the center of the county geographically, is Solano's most complete hospital. It is a designated STEMI receiving center for heart attack patients and the county's only accredited Chest Pain Center. That means only NorthBay Medical Center can handle complicated cardiac cases that require open-heart surgery. Trauma cases can result in patients needing such intervention.

Unlike the Oakland folks' Vacaville hospital, NorthBay Medical Center has a neonatal intensive care unity for seriously ill infants. We already have experienced trauma cases where that capability has made a life-or-death difference. We are no Henry J.-come-lately player when it comes to both obstetrical and infant emergencies. We have had those services for many years.

Handling three times the volume of trauma cases as the other trauma center, a result of our geographic location in the center of the county, NorthBay Medical Center is much more experienced in treating trauma victims. That experience, a result of more than 10 years of designing, building and providing trauma services, makes a difference.

The Oakland folks, even after 65 years in Vallejo, never once evinced an interest in trauma until NorthBay announced its intention. With our encouragement Solano County health officials were able to finish its state-mandated trauma plan to enable trauma centers to be established.

Someone in Oakland either must have been asleep or thought Fairfield and Vacaville were in Yolo County. More likely they found themselves with an incomplete, underutilized new hospital (whose opening was delayed for more than a year after construction was finished) and they needed a way to fill beds. You cannot thrive with an empty hospital.

So no doubt the advertising dollars will continue to flow. But it will be an independent panel of outside experts who will pore over the two proposals and assess which organization has the better system of trauma care. Fortunately for the citizens of Solano County, it won't be decided on who buys the most advertising in newspapers and freeway billboards, or who hosts the most VIP dinners and receptions.

Come October a decision will be made. Should it not go Oakland's way, I suspect a significant legal expense will be incurred by that health plan to appeal and protest its losing proposition.