Doctors Blast Clinic Offering Prenatal Care

After almost a quarter-century of providing prenatal care to low-income East End women and delivering their babies at Southampton Hospital, the physicians at Hamptons Gynecology and Obstetrics in Southampton have refused to renew their contract with the Suffolk County satellite clinic next door.

Some 150 pregnant patients have been told they will have to travel to Brookhaven Memorial Hospital in Patchogue instead, where the doctors who now provide the clinic's prenatal care are on staff.

One of those women, who requested anonymity, lives in East Hampton Town.

"This is my first public health experience," she said, explaining that she had recently fallen on hard times. Six months pregnant with her third child, she said that when labor pains start, it could take her more than an hour to reach Brookhaven Hospital.

"Not In That Place"

The Southampton obstetricians stopped working at the clinic as of Dec. 31, according to one of them, Dr. Allen Ott, because the facility is "not a professional space."

The East Hampton woman said the clinic was "disgusting" and "filthy." Paper diapers are "stuffed into cracks in the windows," she said. She said the facility offered no privacy - and added that she knew "half a dozen names of people who have TB on the East End," whose cases she claimed to have overheard being discussed.

Brookhaven is "pretty far" from the East End, Dr. Ott acknowledged.

"We'd be happy to consider providing the county with our services," he said, "just not in that place. It's like stepping back into the 1940s." He said he had been talking with county officials for "several years" about moving.

Muddy Waters

Dr. Mary E. Hibberd, Suffolk Commissioner of Health since 1991, also wants clinic patients treated in a more suitable space. She escorted a reporter around the facility this week, where 50-year-old floor tiles were pulling up from examining-room subfloors, and where, because room partitions do not reach the ceilings, a resounding sneeze elicited a "Bless you!" from several rooms away.

Water stains were visible in the ceilings throughout the 3,500-square-foot space, and in many rooms, rags were stuffed in the walls to block drafts around air-conditioning units.

The floors were muddy. In one bathroom, Carol Lunt, a nurse-practitioner, leaned down to pick up papers and wipe the floor tiles to demonstrate how they are cleaned most days. A cleaning woman, Ms. Lunt noted, comes once a week.

"Antediluvian"

As long ago as 1993, said Dr. Hibberd, she brought County Executive Robert E. Gaffney to the clinic, housed in the Schenck building in the Southampton Hospital parking lot, to see the less than acceptable conditions. It is owned and maintained by Southampton Hospital.

Calling it "antediluvian - a historical anachronism not appropriate for renovation," Dr. John J. Ferry Jr., the hospital president, said, "If I had my druthers, I'd take it down and add new parking."

The clinic contains an expansive waiting area with examining rooms surrounding it. It "is not anybody's idea of luxury," Dr. Ferry said, "but, frankly, I've seen a lot worse."

Two-thirds of the space is occupied by the clinic and the remainder by the hospital's human resources department, which, by contrast, was repainted, recarpeted, and refurnished in September. The basement is used for hospital storage.

Spanish-Speaking Clientele

In his three years as hospital president, Dr. Ferry said, he has "heard that the county was going to move the clinic," and decided therefore that renovating it was "not a priority."

"A month or two ago," he asserted, he asked for a list of "things that need to be done," but has heard nothing.

Ms. Lunt, the nurse-practitioner, said that of the 175 pregnant women for whom the clinic provided prenatal care last year, more than half came from Bridgehampton and points east. More than 40 percent are Hispanic.

"A good percentage" of those women do not speak English, said Ms. Lunt, who speaks Spanish and is often called upon to interpret for the obstetricians.

Satisfied Patients?

Dr. Hibberd maintained that while the clinic's physical conditions were unsatisfactory, the "O.B. services are excellent."

She said the low-birth-weight rate at the clinic last year was .7 percent, down from 2 percent the year before. The countywide average is 7 percent, she said.

The patients are "satisfied" with the care they receive, she added.

Among the sites the county is considering for the clinic, according to Dr. Ott, are the Flying Point office building on Flying Point Road in Southampton and one of the physicians' office complexes near the hospital.

Space Costs

Dr. Ott estimated the cost of medical space in Southampton at between $20 and $25 a square foot, but thought the county was willing to spend only about half that. The county pays about $2,000 a month to Southampton Hospital.

Jeffrey Martell, an architect in the county's Public Works Department who finds privately owned space for county agencies to lease, declined to be held to a price, saying "everything is negotiable," and there were a lot of variables, such as who renovates the space.

Mr. Martell did say negotiations were under way with owners of at least two buildings, and that he expected to make a presentation "by February" for review by the County Health Department, the County Executive, and the County Legislature.

Making Arrangements

Meanwhile, the Southampton obstetricians have offered East End mothers-to-be the option of being treated in their private offices and arranging with Southampton Hospital to have their babies delivered there. Both the obstetricians and the hospital accept Medicaid, the insurance for low-income families.

In special instances, Dr. Ferry said delivery arrangements could be made through programs such as Hill Burton, which helps low-income patients in small communities obtain free or low-cost medical care.

County officials were reluctant to say why it has taken so long to find suitable space for the clinic. Paul O'Brien, the county's director of health administrative services, said he hoped to move it to a new building "later this year," but that approval for a new lease and any renovations will need the approval of the Suffolk Legislature.

'Space And Staff'

Rick Belyea, a spokesman for Mr. Gaffney, acknowledged that "it has been a long time. This is a very tedious - and that's polite - process." Mr. Belyea said the problem was "a space matter and a staff matter" that he called "crucial now."

In a Dec. 19, 1996, letter to Dr. John E. Hunt Jr. of Hampton Gynecology and Obstetrics, County Executive Gaffney appeared to reiterate Suffolk's commitment to a better clinic.

"My office is committed to finding and leasing new, more suitable, space . . . to improve both the work environment for staff and the clinical accommodations for patients," he wrote.

"Our staffing is not the issue," said Dr. Ott, whose office is expected to bring in an additional physician on July 1. "The patients will be inconvenienced, and we did not want that to happen."

Ferry: It Won't Close

Dr. Donald Bruhn, the clinic's director, himself an obstetrician, declined to comment.

Southampton Hospital's board of directors "would consider" helping the clinic with some funds, Dr. Ferry said, while noting that it was under no obligation to do so.

He dismissed any idea that the county would close the clinic, as was suggested in a Long Island Regional Planning Board report last year that advocated consolidating county clinics such as the Southampton facility, which is a satellite of the Riverhead Health Clinic, to save money.

The Southampton clinic counted 6,200 patient visits last year, including pediatric and adult patients, besides obstetrics. Hamptons Gynecology and Obstetrics received a $21,000 management fee to provide the prenatal and obstetrical care, and about $900 per delivery.