Workers prepare medical tool for sterilization at Brook Army Medical Center’s Sterile Processing Division, Monday, July 24, 2023.
Jerry Lara/San Antonio Express-News
Methodist Healthcare is kicking off a year-long process this week to launch a high-level trauma center at its Northwest Side hospital — despite concerns the new operation could damage Brooke Army Medical Center’s training mission.
BAMC and San Antonio city officials have said for years the creation of new trauma centers that serve the most severely injured people could hurt military medical professionals’ preparations to treat combat injuries by reducing the number of emergency cases BAMC handles each year.
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BAMC and Bexar County-owned University Hospital have the only Level I trauma centers in San Antonio, allowing them to treat the most severely injured people.
Methodist is seeking a Level II designation at its South Texas Medical Center hospital, which would allow the facility to treat people with similar injuries as those at a Level I site, but without requiring it to provide the same training that the highest-level centers usually do.
About 3,500 military medical personnel receive their training at BAMC each year. The facility supports trauma care, graduate medical education, research, specialized care and clinical training.
Together, BAMC and University treat about 13,000 trauma patients each year, said Scott Jackson, the city’s military and veteran affairs director.
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Methodist representatives told city officials earlier this month that they don’t want to compete with the existing trauma centers but are seeking a designation so their patients have the choice to stay within their system, according to the city.
Methodist Healthcare did not comment on its Level II facility for this story.
Jackson and Assistant City Manager Jeff Coyle described the hospital’s plans at a City Council committee meeting on Tuesday.
City Council members are considering a resolution that would voice support for BAMC’s mission and denounce any disruptions to the regional trauma system that “threatens the military missions in San Antonio.”
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The resolution calls on the South Texas Regional Advisory Council to develop a plan to ensure BAMC receives a high volume of patients even if a new trauma center is introduced.
Though it is unclear when the City Council will vote on the resolution, Jackson said STRAC is already working on plans and may have information ready for Methodist and other local parties to review in a month.
STRAC maintains a regional trauma and emergency healthcare system plan for 22 counties. STRAC did not respond to an interview request.
“This is about ensuring readiness for our service members — full stop,” Jackson said. “We have teams of surgeons who train here before they go to war. This is a great place to train. This is about protecting that capability, making them better when they go oversees to take care of our service members.”
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Methodist does not need to seek permission from the city or any local entities to obtain the higher trauma center status. Any agreement the healthcare system strikes with STRAC and BAMC would be voluntary.
The Texas Department of State Health Services has the authority to designate trauma centers. The American College of Surgeons conducts a lengthy review to verify that such facilities have the required equipment and staffing.
Fifteen facilities in San Antonio have trauma designations. Most of them are Level III and IV facilities, which treat less severe wounds and therefore are not seen as a threat to BAMC. The Med Center hospital that Methodist wants to designate as a Level II facility currently has a Level III status.
Coyle and Jackson said Methodist will begin treating the most severely injured patients as part of their pursuit of Level II status on Oct. 1.
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“BAMC deeply appreciates the continued collaboration of the City of San Antonio and our regional healthcare partners,” a BAMC spokesman said in a statement. “Through our longstanding work with the Southwest Texas Regional Advisory Council (STRAC), we remain focused on delivering exceptional patient care to the community while sustaining the vital clinical skills required for military readiness.”
The city’s pushback comes months after San Antonio lost two Army commands at Joint Base San Antonio-Fort Sam Houston to Fort Bragg in North Carolina.
Councilwoman Misty Spears helped spearhead the resolution.
“I love Methodist — it is a wonderful partner in our community,” Spears said. “I just feel BAMC has to be our top priority in preserving their military readiness. That is national security. That is utmost importance as Military City USA.”
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Some of her colleagues called for more data about how the trauma center could affect BAMC before voting on the matter.
University Health, which is the primary teaching hospital for UT Health San Antonio, said in a statement that a Level II trauma center would likely reduce volume and hurt the capabilities of both BAMC and University.
“University Hospital and BAMC have developed a cooperative trauma system in which the public, academic and military sectors complement one another,” the hospital system said. “That partnership benefits civilian patients, wounded warriors, medical education, trauma research and military readiness. Decisions regarding any expansion of trauma centers should be grounded in data, with a goal of protecting the unique partnership on which the entire South Texas region—and our brave service members—depend.”